UC-NRLF 


HEALTH 
EDUCATION 


AND  THL 


PREPARATION  of 
TEACHERS 

LAKE  MOHONK  CONFERENCE 


PUBLISHED  BY 

CHILD  HEALTH  ORGANIZATION 

of  oAmerica 

370  SEVENTH  AVENUE 
NEW  YORK 

1922 


Report  of  Conference 


on 


HEALTH   EDUCATION 


and  the 


PREPARATION   of  TEACHERS 


Called  by 


The  U.  S.  Bureau  of  Education 

and 
The  Child  Health  Organization 

of  America 


AT 


LAKE  MOHONK,  NEW  YORK 
JUNE  26      -      JULY  1,  1922 


.-;-.  ;,  :T;;&;B  t  E/.-.O'F   CONTENTS 

PAGE 
PROGRAM  ......................................       4 

FOREWORD    ...............  ,  ....................       6 

Section  I 

INTRODUCTIONS   ...............................       8 

Dr.  Thomas  D.  Wood  —  8;  Dr.  L.  Emmett  Holt  —  9;  Miss 
Sally  Lucas  Jean—  12;  Dr.  Willard  S.  Small—  14;  Mr. 
Daniel  Chase  —  18. 


Section  II 
SUBJECT  MATTER  IN  HEALTH  EDUCATION  .....     22 

The  Objectives  and  Content  of  Formal  Instruction  in 
Hygiene,  by  Dr.  C.-E.  A.  Winslow  —  22;  Discussion,  by 
Professor  C.  D.  HarW29;  Dr.  Wood,  Dr.  Small—  30;  Miss 
Emma  Dolfinger,  Mr.  A.  L.  Safford,  Dr.  Walter  Brown, 
Mrs.  Lucy  M.  Paul—  31;  Mrs.  Isabelle  W.  Baker,  Miss 
Jean,  Mr.  Lewis  H.  Carris  —  32;  Dr.  H.  E.  Kleinschmidt  — 
33  ;  Content  of  a  Health  Education  Program,  by  Dr.  Lerpy 
A.  Wilkes  —  34;  Discussion,  by  Miss  Ethel  Beard,  Miss 
Elma  Rood  —  41;  Miss  Jean,  Mr.  Charles  M.  DeForest,  Mr. 
Safford  —  42;  Miss  Julia  B.  Tappan,  Dr.  Wilkes,  Miss 
Ethel  Perrin  —  43;  Dr.  Wood  —  44;  Food  and  Health 
Education,  by  Dr.  E.  V.  McCollum  —  44;  Discussion,  by  Miss 
Edna  White—  52  ;  Miss  Adelaide  S.  Baylor,  Dr.  Wilkes—  53  ; 
Miss  Jean,  Dr.  Wood,  Mrs.  Henrietta  Calvin,  Miss  Laura 
A.  Cauble  —  54;  Miss  Jessie  Hoover,  Dr.  Richard  A.  Bolt 
—55. 

Section  III 

THE  PLACE  OF  HEALTH  EDUCATION  IN  THE 

CURRICULUM  ..............................  56 

The  Place  of  Health  Education  in  the  Programs  of  Schools 
and  Colleges,  by  Dr.  Maurice  A.  Bigelow  —  56;  Discussion, 
by  Dr.  Caroline  Croasdale  —  63  ;  Dr.  Winslow,  Miss  Mary  G. 
McCormick,  Miss  Katherine  A.  Pritchett,  Miss  White—  65; 
Place  of  Health  Education  in  the  Curriculum,  by  Mrs.  Lucy 
Paul  —  66;  Discussion,  by  Miss  Marion  Lerrigo  —  70;  Mr. 
Chase,  Dr.  Winslow,  Dr.  Wood,  Dr.  Small,  Miss  Julia  Wade 
Abbot—  71  ;  Dr.  Bigelow—  72  ;  The  Place  of  Health  Educa-  4 
tion  in  Elementary  Schools,  by  Miss  Emma  Dolfinger  —  72  ; 
Discussion,  by  Miss  Mary  Moriarty  —  75  ;  Miss  Abbot,  Miss 
Moriarty  —  77;  Miss  Effie  Knowlton,  Dr.  Franklin  Barrows 
—  78;  Miss  Gertrude  Whitton,  Professor  C.  E.  Turner  —  79; 
Miss  Jeanie  Pinckney,  Dr.  Edwards,  Miss  Mary  A.  S.  Mugan 
—80;  Dr.  Wood,  Mr.  Safford—  81. 


PAGE 
Section  IV 

PROMOTION  OF  HEALTH  HABITS 82 

INCENTIVES  AND  MOTIVES 

Health  in  Early  Childhood,  by  Professor  Patty  S.  Hill— 82 ; 
Discussion,  by  Miss  Harriet  Wedgwood,  Miss  White — 87; 
Miss  Rood,  Miss  Perrin,  Professor  Hill — 88;  Dr.  Bar- 
rows— 89;  Interests  of  Young  Children  as  the  Basis  for 
Health  Teaching  in  the  Kindergarten,  by  Miss  Julia  Wade 
Abbot — 89;  Discussion,  by  Miss  Jennie  Haver — 98;  Miss 
Jean,  Miss  Haver,  Miss  Dolfinger,  Miss  Mary  Spencer — 
100;  Dr.  Mary  Brydon,  Miss  Haver — 101;  Miss  Margaret 
Sparks — 102;  Incentives  and  Motives^  in  Health  Education, 
by  Miss  Mabel  Bragg — 102;  Discussion,  by  Miss  Mugan — 
105;  Miss  Belle  Kirk,  Mr.  DeForest— 106 ;  Miss  Pritchett, 
Dr.  Brown— 107. 

SUCCESSES  AND  FAILURES 

Successes  and  Failures  in  Teaching  Health  Habits,  by 
Miss  Maud  Brown — 108;  Discussion,  by  Miss  Sparks — 119; 
Dr.  Wilkes — 124;  Dr.  Bigelow,  Miss  Bragg,  Dr.  Wood — 
126;  Dr.  Bigelow,  Professor  Turner — 127;  Miss  Mary 
Murphy,  Dr.  Kleinschmidt — 128 ;  Failures  and  Successes  in 
the  Promotion  of  Health  Habits,  by  Miss  Ethel  Perrin — 
129;  Discussion,  by  Miss  Helen  Freeborn — 132;  Professor 
Turner,  Miss  Lewis — 134;  Home  Hygiene  and  Care  of  the 
Sick,  by  Mrs.  Isabelle  Baker — 135;  Discussion,  by  Miss 
Rood — 140;  Dr.  Brydon,  Miss  Estella  Bogardus,  Miss  Jean, 
Miss  Perrin — 144;  Miss  Anna  Ruth  Medcalf — 145;  Dr. 
Wilkes— 146. 

Section  V 

THE  PREPARATION  OF  TEACHERS  IN  HEALTH 

EDUCATION 148 

The  Preparation  of  Teachers-in-I 'raining,  by  Dr.  Willard 
S.  Small — 148;  Discussion,  by  Dr.  Barrows,  Miss  C.  M. 
Scovel— 154;  Dr.  Alyin  Powell,  Dr.  Wilkes— 155;  Miss 
Lewis — 156;  The  Training  of  Specialists  in  Health  Educa- 
tion, by  Professor  C.  E.  Turner — 157;  Discussion,  by  Dr. 
Anna  Gove — 162;  Dr.  Brown,  Miss  Knowlton — 163;  Dr. 
Wilkes— 164;  Dr.  Brydon— 165;  Health  Education  for 
Teachers  Through  Home  Economics,  by  Professor  Flora 
Rose — 167;  Discussion,  by  Miss  Margaret  Sawyer — 172; 
Commonwealth  Fund  Announcement,  by  Miss  Jean — 173. 

Section  VI 
RECOMMENDATIONS  175 

Report  of  the  Committee  on  Teacher-Training  for  Health 
Education — 175 ;  Student  Health  Service — 177 ;  Resolutions 
—178. 

THE  GUESTS  .  179 


Health!         Strength!        Joy! 


Chairman  of  Sessions 
DR.  THOMAS  D.  WOOD 

Teachers'  College,  Columbia  University 

Addresses  of  Welcome 

DR.  L.  EMMETT  HOLT  (Child  Health  Organization) 

DR.  WILLARD  S.  SMALL  ( U.  S.  Bureau  of  Education) 

MR.  DANIEL  CHASE  (N.  Y.  State  Department  of  Education) 

Subject  Matter  in  Health  Education 

Papers  presented  by  Discussion  led  by 

DR.  C.-E.  A.  WINSLOW  PROF.  C.  D.  HART 

DR.  LEROY  A.  WILKES  Miss  ETHEL  BEARD 

DR.  E.  V.  MCCOLLUM  Miss  EDNA  WHITE 

The  Place  of  Health  Education  in  the  Curriculum 

Papers  presented  by  Discussion  led  by 

DR.  MAURICE  A.  BIGELOW      DR.  CAROLINE  CROASDALE 
MRS.  LUCY  PAUL  Miss  MARION  LERRIGO 

Miss  EMMA  DOLFINGER          Miss  MARY  MORIARTY 

Incentives  and  Motives  in  Health  Education 

Papers  presented  by  Discussion  led  by 

Miss  JULIA  ABBOT  Miss  JENNIE  HAVER 

PROF.  PATTY  HILL  Miss  HARRIET  WEDGWOOD 

Miss  MABEL  BRAGG  Miss  MARY  MUGAN 


•      The  Promotion  of  Health  Habits — Successes  'and ' 'Failures 
—'••*:•?>::  /. 
Papers  presented  by 


Miss  MAUD  BROWN  Miss  MARGARET  SPARKS 

Miss  ETHEL  PERRIN  Miss  HELEN  FREEBORN 

MRS.  ISABELLE  BAKER  MlSS  ELMA  ROOD 

The  Preparation  of  Teachers  in  Health  Education 

Papers  presented  by  Discussion  led  by 
DR.  W.  S.  SMALL  DR.  FRANKLIN  BARROWS 

PROF.  C.  E.  TURNER  DR.  ANNA  GOVE 

Miss  FLORA  ROSE  Miss  MARGARET  SAWYER 


PROGRAM  COMMITTEE 

DR.  C.-E.  A.  WINSLOW 
Chairman 

DR.  THOMAS  D.  WOOD 
Chairman  of  Sessions 

DR.  JOHN  R.  FINLEY 
DR.  MARY  SWARTZ  ROSE 
DR.  ALBERT  SHIELS 
DR.  WILLARD  S.  SMALL 
DR.  RAY  L.  WILBUR 
MR.  WILLIAM  WIRT 


Health  in   \**^  Y^     I  Education 
Education    \       V  /in  Health 


The  Talking  Oak 

WHEN  Jason  was  grown  up,  you  remember,  he 
decided  to  go  on  the  glorious  adventure  of  the 
quest  of  the  Golden  Fleece.  This  fleece  once  cov- 
ered a  ram  who  had  been  trusted  to  bring  two  children 
into  safety.  Jason  was  perplexed  as  to  how  the  adventure 
should  begin  so  he  consulted  the  Talking  Oak. 

A  great  many  of  us  have  set  forth  on  the  quest  of  the 
Golden  Fleece  of  Universal  Child  Health  as  the  most  glori- 
ous adventure  which  grown-ups  today  can  undertake.  We 
are  often  perplexed  as  to  how  to  proceed.  And  so  we  con- 
sult the  Talking  Oak.  That  is,  we  hold  a  conference. 

The  first  time  this  happened  was  in  December,  1920. 
Then  the  Child  Health  Organization  of  America  called  a 
Conference  of  fifty  interested  people  to  discuss  the  question : 
Can  health  be  taught  to  children,  and  if  so,  who  can  do  it 
best?  The  Conference  decided  that  it  could  be  done  and 
that  just  as  Jason  was  instructed  to  find  fifty  heroes  to 
accompany  him  on  his  adventure,  so  must  teachers  all  over 
the  country  be  enlisted  to  bring  the  quest  of  Child  Health 
to  a  successful  conclusion. 

And  so  the  Child  Health  Argo  was  launched.  Since 
then  it  has  cruised  around  the  world,  As  a  result  a  tre- 
mendous interest  in  the  teaching  of  health  to  children  in 
the  schools  has  been  aroused.  Child  psychology  has  been 
applied  to  teaching  methods,  and  "the  dry  bones  of  physi- 
ology and  hygiene  live  again,"  clothed  with  interesting 
facts  and  winged  with  imagination. 

But  the  Argonauts  have  not  yet  come  into  possession  of 
the  Golden  Fleece,  although  here  and  there  shining  bits  of 
it  have  been  won.  Several  new  questions  of  direction  have 
been  formulated  and  future  teachers  need  to  be  given  better 
preparation  before  they  join  the  quest. 

This  preparation  must  include  the  inspiration  that  a 
glorious  adventure  requires  of  its  followers,  radiant, 
abundant  health,  and  bedrock  knowledge  of  the  subject 


matter  of  physiology  and  hygiene  and  the  technique  of 
teaching  methods. 

To  determine  how  teachers  can  best  be  trained  to  follow 
the  quest  of  Universal  Child  Health  was  the  main  ques- 
tion that  caused  the  U.  S.  Bureau  of  Education  and  the  Child 
Health  Organization  of  America  to  consult  the  Talking  Oak 
once  more. 

They  invited  authorities  in  the  scientific  and  educational 
fields  to  come  to  Lake  Mohonk,  New  York,  the  last  week  in 
June,  1922,  and  there  talk  over  "Health  Education  and  the 
Preparation  of  Teachers."  One  hundred  people  accepted 
and  the  names  you  will  find  on  page  179.  Probably  the 
Talking  Oak  has  never  flourished  in  so  beautiful  a  place  as 
Lake  Mohonk.  Certainly  it  was  never  so  well  cared  for. 
From  Mrs.  Smiley,  the  hostess,  to  the  smallest  bell-hop  of 
all — from  hail  to  farewell — the  members  of  the  Confer- 
ence were  made  to  feel  the  imprint  of  genuine  kindly  hos- 
pitality. 

Most  of  you  who  read  this  report  were  unable  to  come 
to  the  Conference,  but  here  you  will  find  the  papers  in 
full,  the  moot  points  in  the  discussion  of  important  ques- 
tions and  the  significant  recommendations  formulated. 

In  order  to  relate  more  clearly  to  their  subjects  some  of 
the  important  points  brought  out  in  discussion,  it  has  been 
necessary  to  rearrange  certain  parts  of  the  report.  For 
instance,  the  proceedings  of  the  Monday  evening  Round 
Table  Conference  and  the  Friday  morning  meeting  have 
been  included  in  the  account  of  the  sessions  to  which  they 
apply. 

We  hope  this  report  will  be  to  Teacher-Training  Institu- 
tions and  to  individuals  a  valuable  guide  in  planning  a 
Student  Health  Service  and  course  of  study. 


'•'-'      :    .-.    '    '• 

:**  ;  .-  •  -  >*:*«•    :  ; .,:  ;••.  *.* 

Section  I 

INTRODUCTIONS 

THUS  it  came  about  that  the  group  of  men  and  women, 
whose  names  appear  on. page  179,  assembled  at  Lake 
Mohonk,  to  consider  the  problem  of  the  "When,"  the 
"How,"  and  the  "Where"  of  training  teachers  for  that  most 
important  function,  the  Health  Education  of  the  children 
committed  to  their  charge.     The  first  evening  was  given 
over  to  introductions — first,  of  the  problems  to  be  consid- 
ered;  and   second,   of  the   people   who   were   to   do   the 
considering. 

To  preserve  the  spirit  of  the  Conference  as  well  as  pos- 
sible in  this  report,  a  literal  transcription  of  the  proceed- 
ings is  here  given,  except  where  the  limitations  of  space 
demand  the  condensation  of  discussions.  Therefore  the 
meeting  is  at  this  point  turned  over  to  Dr.  Thomas  D. 
Wood,  Teachers'  College,  Columbia  University,  Chairman 
of  the  Sessions: 

WE  are  met  in  a  unique  place — here  at  Lake  Mohonk — 
and  this  is  a  unique  Conference.  So  far  as  I  know  it  is 
the  first  conference  of  its  name  and  type  which  has  been  held 
in  this  country.  To  some  of  us  there  seems  to  have  been  no 
more  significant  or  graphic  effect  of  the  war  upon  this 
country  than  the  realization  of  the  meaning  of  health,  of 
physical  fitness,  to  the  welfare  of  the  world.  We  need 
not  review  the  evidence  which  brought  this  home  to  the 
American  people.  There  is  no  more  significant  outstand- 
ing development  in  our  modern  program  of  public  educa- 
tion than  that  which  relates  to  the  health  of  the  children  in 
our  schools.  There  had  been  attempts  made  for  a  half- 
century  to  take  care  of  the  health  of  the  school  children  and 
to  give  them  instruction  in  matters  relating  to  health.  It 
had  been  slow,  inefficient,  rather  desultory,  and  not  very 
successful.  The  war  has  brought  about  great  change,  and 
it  is  in  part  as  a  result  of  this  that  this  Conference  meets 
here  this  week,  under  the  auspices  of  the  United  States 
Bureau  of  Education  and  the  Child  Health  Organization 
of  America. 

(8) 


It  gives  me  great  pleasure  to  introduce  to  the  members 
of  this  Conference,  as  the  first  speaker,  the  President  of 
the  Board  of  Trustees  of  the  Child  Health  Organization — 
Dr.  L.  Emmett  Holt  of  New  York. 


Dr.  Holt: 

Mr.  Chairman,  Ladies  and  Gentlemen: 

IT  is  my  pleasant  duty  to  welcome  you  to  this  Conference, 
the .firsj^of  itsjkind  ever  held ;  but  I  am  sure  not  the  last. 
The  Child  Health  Organization  has  joined  with  the  U.  S. 
Bureau  of  Education  in  calling  the  Conference,  but  wishes 
it  distinctly  understood  from  the  outset  that  it  is  to  be  a 
real  conference.  No  cut-and-dried  program  has  been  formu- 
lated which  you  are  to  be  asked  to  endorse.  We  have  come 
to  discuss  questions  of  great  interest  at  the  present  time; 
questions  regarding  which  no  doubt  much  difference  of 
opinion  exists.  This  is  a  real  advantage.  If  we  all  were  in 
agreement  such  a  conference  would  be  unnecessary. 

The  subject  of  the  Health  Education  of  Children,  which 
is  the  main  one  which  has  brought  us  together,  is  a  com- 
paratively new  one,  still  in  its  plastic  formative  stage.  How 
it  develops,  how  it  is  guided  and  what  becomes  of  this 
movement  is  largely  in  the  hands  of  the  men  and  women 
who  are  in  this  room  tonight. 

A  great  many  experiments  have  been  tried  in  different 
parts  of  the  country  in  directing  the  Health  Education  of 
Children;  some  in  our  schools  and  some  out  of  them. 
Some  of  these  have  been  very  successful,  some  have  had 
a  minor  degree  of  success  and  some  have  been  quite  un- 
successful. 

We  hope  to  be  able  in  our  discussion  this  week  to  sift 
out  the  methods,  the  agencies  and  subject  matter  which 
seem  most  worth  while,  and  which  deserve  to  be  continued 
and  developed,  and  also  to  decide  those  which  are  not  worth 
while  and  which  should  be  dropped  altogether.  We  hope, 
therefore,  to  have  the  fullest  and  frankest  possible  discus- 
sion upon  the  various  topics  which  are  to  come  up  for  our 
consideration.  Only  in  this  way  can  a  conference  like  this 
justify  itself. 

Possibly  a  few  words  regarding  the  circumstances  which 
led  to  the  formation  of  the  Child  Health  Organization  may 


10 

not  be  out  of  place,  since  the  facts  may  not  be  familiar  to 
all  of  you. 

During  the  war,  when  so  many  physicians  went  into 
military  service,  a  group  of  pediatrists,  members  of  the 
New  York  Academy  of  Medicine,  who  could  not  go,  formed 
a  committee  known  as  the  Committee  on  War-Time  Prob- 
lems of  Children.  The  committee  had  no  very  definite  pro- 
gram in  mind,  but  were  moved  by  a  desire  to  do  something 
for  the  children  of  this  country,  especially  those  of  school 
age,  whose  health  and  nutrition  seemed  to  be  overlooked 
on  account  of  the  great  efforts  which  were  being  made  for 
the  children  of  Europe. 

The  physicians  became  associated  with  a  group  of  social 
workers  of  the  People's  Institute  of  New  York. 

Representatives  of  the  two  groups  went  to  Washington 
and  secured  the  interest  of  Secretary  Franklin  K.  Lane  of 
the  Department  of  the  Interior.  He  promised  his  active 
cooperation,  but  said — "The  health  of  the  children  of  the 
entire  country  is  involved;  and  not  a  small  local  committee 
but  a  large  national  one  should  be  formed.  The  United 
States  Bureau  of  Education  in  the  Department  will  do  every- 
thing possible  to  carry  out  the  plans  which  you  have  in 
view."  The  cooperation  which  Secretary  Lane  promised 
was  given  during  his  entire  term  of  office,  and  it  was  con- 
tinued by  his  successors. 

Part  of  the  time  a  member  of  the  Child  Health  Organi- 
zation staff  was  under  appointment  in  the  Bureau  of 
Education  at  Washington,  and  through  this  Bureau  a  great 
deal  of  literature  relating  to  the  health  of  children,  which 
had  been  prepared  by  the  Child  Health  Organization,  was 
distributed  to  the  schools  of  the  country. 

In  the  beginning  our  interest  was  chiefly  in  improving 
nutrition  through  the  establishment  of  school  lunches  and 
through  literature  relating  to  the  diet  of  school  children. 

We  very  soon  found  that  the  problem  involved  other 
and  larger  considerations.  In  a  few  months  we  came  to 
the  conclusion  that,  just  as  the  problem  of  infant  mortality 
had  been  solved  chiefly  through  the  education  of  the  mother, 
definite  improvement  in  the  health  and  nutrition  of  the 
school  child  could  be  secured  only  through  the  education  in 
health  of  the  children  themselves.  Thus  we  were  drawn, 
without  our  intention,  into  the  educational  field  and  our 


11 

aim  has  been  in  the  common  phrase  of  the  day — "to  put 
Health  Education  on  the  map." 

The  slogan  selected  for  the  Child  Health  Organization 
was  Health  in  Education — Education  in  Health;  and  it  is 
to  the  spread  of  the  two  ideas  that  the  organization  has 
addressed  itself  during  the  four  years  of  its  existence. 

In  all  our  health  movements  the  part  which  private 
organizations  have  played  is  a  very  important  one.  It  is 
they  who  have  gone  ahead  and  blazed  the  way  which  has 
later  been  followed  by  governmental  and  other  official  agen- 
cies. This  has  been  true  of  the  campaign  against  tubercu- 
losis, against  infant  mortality  and  many  others.  These 
movements  began  in  a  small  way  with  a  single  group.  So 
we  hope  it  may  be  with  the  Health  Education  of  Children. 
We  hope  and  expect  to  see  this  extend  until  it  embraces  all 
the  children  in  all  the  schools  of  our  country. 

I  think  we  will  agree  it  to  be  the  function  of  education 
to  prepare  the  rising  generation  for  the  duties  and  responsi- 
bilities of  life,  and  certainly  there  is,  next  to  moral  instruc- 
tion, nothing  more  important  than  instruction  in  health. 
We  aim  to  make  this  as  much  a  part  of  regular  school  in- 
struction as  that  in  the  "three  R's."  This  program  involves 
the  bringing  together  of  two  important  groups,  which  have 
not  always  and  everywhere  worked  together  in  closest  co- 
operation, viz.,  the  health  authorities  and  the  school  authori- 
ties. How  this  can  be  done  is  one  of  the  problems  which 
meets  us  today. 

The  Chairman  has  said  that  much  of  the  health  instruc- 
tion given  in  the  past  has  been  desultory  and  ineffective.  I 
think  that  we  may  go  even  further  and  say  that  in  very 
many  cases  its  only  result  has  been  to  make  health  repulsive. 
The  aim  of  the  present  movement  in  Health  Education  is  to 
make  health  interesting  and  attractive.  Our  experience 
leads  us  to  believe  that  this  is  quite  possible. 

What  I  hope  we  may  accomplish  in  this  Conference  is  to 
determine,  first,  what  regarding  health  can  be  taught  to 
children ;  and,  secondly,  how  best  to  teach  it. 

What  we  decide  upon  in  our  Conference  here  this  week 
is  bound  to  exert  a  wide  influence,  perhaps  determine  what 
will  be  done  in  this  country  during  the  next  few  years  in 
Health  Education.  I  hope  we  all  realize  our  responsibility 
and  our  great  opportunity. 


12 

The  following  address,  prepared  for  the  opening  session 
but  not  delivered,  is  here  inserted,  because  it  presents 
another  aspect  in  the  development  of  the  Health  Education 
movement.  Miss  Sally  Lucas  Jean,  Director  of  the  Child 
Health  Organization,  speaks  as  follows : 

YOU  have  been  welcomed  by  Dr.  Holt  in  the  name  of  the 
Child  Health  Organization,  but  I,  too,  am  glad  indeed 
of  the  opportunity  to  extend  my  heartiest  greetings  to  you 
all. 

When  a  committee  of  the  Pediatric  Section  of  the  New 
York  Academy  of  Medicine  sent  a  representative  to  Wash- 
ington four  years  ago  to  confer  with  Franklin  K.  Lane, 
then  Secretary  of  the  Department  of  the  Interior,  about 
the  prevalence  of  malnutrition  among  school  children  in 
New  York,  there  was  little  thought  of  the  tremendous 
strides  to  be  taken  within  a  few  years.  Mr.  Lane  immedi- 
ately urged  the  formation  of  a  national  group  to  raise  the 
health  standard  of  the  American  School  Child.  With  the 
confidence  of  such  a  statesman  invitations  were  extended 
to  educators  and  socially  minded  individuals  living  in  all 
sections  of  the  country.  The  response  was  amazing,  all 
accepting  but  two  from  a  list  of  twenty-seven.  A  small 
budget  was  raised  and  the  Child  Health  Organization 
launched.  Just  how  a  new  private  association  could  assist  a 
national  department  as  they  were  invited  to  do  was  some- 
what vague,  but  as  Secretary  Lane  said,  "If  you  have  enough 
red  blood,  it  can  be."  The  Director  of  the  Organization 
was  appointed  on  the  dollar-a-year  basis  in  the  Bureau  of 
Education  and  a  printing  fund  allowed.  Dr.  Small  wel- 
comed assistance  and  gave  support  at  every  turn  which 
made  cooperation  possible.  As  I  look  back  to  the  letters 
which  came  both  to  the  Bureau  and  the  Child  Health  Or- 
ganization during  those  first  few  months  from  teachers, 
I  seem  to  see  their  earnest  faces  rise  before  me,  all  begging 
for  help  in  methods  of  interesting  children  themselves  in 
building  stronger  bodies.  As  one  teacher  wrote  us,  "The 
ideas  you  send  us  are  good.  I  appreciate  your  help  but  I 
don't  know  quite  how  to  go  ahead."  As  each  letter  was 
answered  personally  in  addition  to  carefully  developed 
printed  matter,  it  was  possible  to  suggest  ways  and  means 
of  meeting  each  particular  situation  and  always  to  add  that 
the  teacher  herself  possessed  a  laboratory  in  her  classroom 


13 

of  pupils  from  which  we  hoped  for  help.  Our  faith  was  soon 
rewarded.  A  large  proportion  of  the  letters  brought  ideas, 
methods,  devices  which  though  sometimes  expressed  in  Eng- 
lish that  would  scarcely  warrant  our  belief  that  the  teacher 
herself  had  been  through  High  School,  carried  the  earmarks 
of  practical  application. 

City  and  State  superintendents  became  interested  many 
times  through  their  teachers'  enthusiasm  and  requests  for 
a  course  of  study  were  frequent,  and  to  meet  this  need  a 
Conference  was  called  in  December,  1920.  Fifty  people 
gathered  together  from  all  sections  of  the  country  for  a 
three  days'  meeting — many  of  you  participating  at  that 
time. 

The  Conference  was  instrumental  in  bringing  many 
people  together  who  had  been  working  in  the  same  field 
along  parallel  lines  unconscious  of  each  other.  The  move- 
ment was  undoubtedly  advanced  and  ultimately  "Sugges- 
tions for  Health  Teaching  in  the  Elementary  Schools"  was 
issued.  Much  work  has  been  done  since  then,  almost  a  new 
point  of  view  created.  From  all  over  the  world  we  are  asked 
for  assistance  in  teaching  health  to  school  children.  Now 
we  all  recognize  that  this  is  a  problem  for  the  doctor  and 
the  educator  to  work  out  together. 

The  educator  has  not  been  encouraged  to  interpret  the 
knowledge  of  the  doctor.  That  has  been  the  task  which 
this  Organization  set  for  itself,  and  now  the  demand  for 
leaders  in  this  field  has  gone  beyond  the  supply.  From  the 
answers  to  a  questionnaire  sent  out  this  spring  to  all  teacher- 
training  centers  in  the  United  States  it  is  evident  that  the 
supply  of  well  trained  health  teachers  is  not  rapidly  in- 
creasing. 

There  is  little  uniformity  in  the  health  courses  offered, 
from  1  to  6  hours  being  allowed,  and  moreover,  these  courses 
are  frequently  elective.  Fifteen  different  titles  are  used  in 
describing  the  courses.  Practice  teaching  in  health  subjects 
is  rather  the  exception  than  the  rule. 

The  health  of  students  themselves  does  not  appear  to 
play  an  important  part  beyond  the  physical  examination, 
which  is  put  on  record  and  forms  the  basis  for  physical 
exercise  to  be  allowed  or  encouraged. 

The  increased  interest  in  health  teaching  has  grown  out 
of  an  idea — the  idea  that  health  could  be  made  interesting 


14 

to  children  themselves.  We  are  here  to  consider  how  best 
we  can  pass  that  idea  on  to  the  children  in  the  schools  of 
the  world. 

The  Chairman  then  introduced  Dr.  Willard  S.  Small, 
Specialist  in  School  Hygiene  and  Physical  Education,  Bu- 
reau of  Education,  Department  of  the  Interior,  Washington, 
D.  C. 

Dr.  Small: 

Members  of  the  Conference,  Ladies  and  Gentlemen : 

THE  Bureau  of  Education  has  occasion  to  seek  the  help 
and  cooperation  of  a  great  many  voluntary  organiza- 
tions which  are  devoted  to  different  aspects  of  educational 
promotion  and  improvement.  Of  course,  it  is  always  im- 
proper to  speak  of  one's  poverty,  either  personal  or  official, 
but  I  think  it  would  do  this  audience  no  harm  to  know  that 
the  U.  S.  Bureau  of  Education,  which  is  supposed  in  some 
mysterious  way  to  exert  an  influence  for  good  upon  a  great 
variety  of  educational  activities  in  the  country  has  for  that 
magnificent  service,  a  munificent  annual  appropriation  of 
about  $160,000. 

I  will  not  weary  you  with  statistics,  but  you  may  be  in- 
terested to  know  that  the  Bureau  has  published  and  issued 
to  the  public  something  more  than  one  million  pieces  of 
literature  of  one  kind  or  another  bearing  upon  Health 
Education  or  the  health  teaching  of  children.  This  is  within 
the  last  four  years.  The  Child  Health  Organization,  for 
the  most  part,  has  been  the  producing  agency  for  that  litera- 
ture; the  Bureau  of  Education  has  been  the  distributing 
agency.  Why?  Because  the  Bureau  of  Education  has  nat- 
ural and  effective  access  to  the  schools  of  the  country. 
By  reason  of  the  fact  that  we  do  have  this  access  to  the 
schools  of  the  country,  we  were  able  to  begin,  as  soon  as 
the  Child  Health  Organization  had  some  goods  to  market, 
to  market  the  goods.  We  first  distributed  only  one  or  two 
slender  pamphlets  and  the  Classroom  Weight  Record.  Soon 
we  began  to  get  returns  from  these  publications.  From  here 
and  there  over  the  country,  responses  began  to  come  in 
and  you  may  be  interested  to  know  that  some  of  the  most 
useful  information  and  valuable  responses  came  not  alone 
from  those  who  occupied  the  high  positions  in  the  educa- 
tional hierarchy,  but  from  untrained  or  self -trained  teachers. 


15 

We  have  carried  on  for  the  past  four  years  a  very  large 
correspondence,  with  not  only,  as  I  say,  important  school 
officials,  but  also  with  apparently  unimportant  teachers  all 
over  the  country.  We  have  gathered  a  constantly  increas- 
ing mass  of  information  in  regard  to  the  problems  of  health 
teaching,  and  have  made  some  attempt  to  analyze  this.  For 
instance,  we  are  able  to  say  from  time  to  time  what  kind 
of  new  literature  is  needed  in  order  to  answer  a  certain  per- 
centage of  inquiries  that  come  from  teachers  all  over  the 
country. 

Now,  it  may  further  interest  you  to  know  that  although 
we  have  made  our  primary  approach  to  the  schools  of  the 
country,  as  we  properly  should,  yet  in  larger  and  larger 
measure  our  correspondence  and  our  lines  of  contact  have 
gone  in  other  directions — not  only  to  teachers,  but  to  nurses, 
to  the  agents  of  the  Tuberculosis  Association,  to  the  agents 
of  the  Red  Cross,  to  the  Home  Economics  workers  of  the 
States,  to  almost  every  variety,  not  only  of  educational,  but 
of  semi-educational  and  accessory  institutions;  and  to  the 
health  departments  of  city,  county  and  State  all  over  the 
country. 

I  am  refraining,  as  Dr.  Holt  refrained,  from  telling  you 
where  you  are  going.  I  am  more  and  more  impressed  as 
I  come  to  know  better  the  kind  of  problem  that  is  put  up  to 
us  from  all  over  the  country — I  am  more  and  more  impressed 
with  the  fact  that  we  are  just  on  the  outskirts  of  this  prob- 
lem of  health  in  education  and  that  the  problem  is  not  going 
to  be  solved  in  the  office  of  the  Bureau  of  Education  or  in 
the  office  of  the  Child  Health  Organization  or  in  the  chair  of 
Hygiene  or  Health  Education  in  any  university,  although 
all  these  will  be  important  contributing  agencies,  but  the 
problem  is  going  to  be  solved  largely  by  the  field  workers — 
those  who  are  on  the  firing  line.  Some  of  the  most  impor- 
tant contributions  to  sound  methods  of  guiding  children  into 
an  appreciation  and  love  and  practice  of  health,  as  I  said 
a  few  moments  ago,  have  come  from  apparently  very  unim- 
portant persons. 

The  thing  that  we  know  today  is  important  and  the 
thing  that  we  are  trying  to  do  in  the  Bureau  of  Education, 
in  cooperation  with  the  Child  Health  Organization  and  other 
organizations,  is  to  understand  and  interpret  the  experi- 
ences, both  positive  and  negative,  that  come  to  us  from  the 


16 

field — to  interpret  and  retranslate  those  so  that  they  will  be 
useful  to  the  teachers  everywhere. 

We  have  not  as  yet,  in  any  large  measure,  solved  the 
problems  of  method,  and  I  am  very  hopeful  that  this  gather- 
ing which  is  assembled  here  will  give  substantial  aid  in  solv- 
ing these  problems. 

I  heard  last  Friday  night  at  a  meeting  of  the  National 
Conference  of  Social  Work,  which  is  having  its  session  in 
Providence,  a  most  interesting  and  significant  address  by 
Mr.  Prentice  Murphy  of  Philadelphia.  Mr.  Murphy  gave  a 
historical  sketch  of  the  progress  of  the  theory  of  social  work 
during  the  last  15  years ;  and,  as  the  conclusion — which  he 
repeated  several  times  in  various  ways — as  the  conclusion 
of  his  historical  sketch,  he  made  a  statement  something  like 
this:  That  more  is  to  be  accomplished  through  the  public 
schools  in  the  solution  of  social  problems  than  all  the  special 
institutions  and  the  special  organizations  for  uplift  work 
can  ever  accomplish.  As  I  listened  to  Mr.  Murphy  the 
thought  kept  recurring  in  my  mind:  'That  is  probably 
right,  Mr.  Murphy,  but  it  means  quite  as  much  in  the  way 
of  transformation  of  our  schools,  of  our  purposes  and  aims 
in  education,  as  it  does  in  the  transformation  of  method  in 
social  work."  It  sometimes  seems  as  though  the  dead  hand 
of  the  past — two  hands,  indeed — were  lying  very  heavy  upon 
the  schools  of  today — two  legacies  of  ideas  in  regard  to 
education  that  today  instead  of  being  sources  of  power  are 
deterrent  and  devitalizing.  The  protestant  reformation 
bequeathed  us  the  idea  that  education,  at  least  elementary 
education,  is  purely  a  matter  of  literacy — being  able  to 
read  and  write  language.  Why?  Because — and  Martin 
Luther  made  this  very  plain — we  are  to  be  saved  by  our 
knowledge  of  the  Scriptures ;  and  if  we  are  to  be  saved,  we 
must  all  be  able  to  read  the  Scriptures.  Therefore,  educa- 
tion is  the  acquirement  of  literacy.  And  for  three  centuries 
that  conception  has  dominated  all  our  thought  and  effort  in 
the  field  of  popular  education. 

This  conception  was  strongly  reinforced  by  the  political- 
educational  ideas  that  sprang  up  in  this  country  during  the 
early  days  of  the  American  Commonwealth — the  bequest 
of  Jefferson  and  his  confreres.  And  what  were  these  ideas? 
This  is  a  democratic  government ;  a  democratic  government 
depends  for  its  success  upon  the  intelligence  of  the  elec- 


17 

torate — the  masses ;  therefore  the  masses  must  be  educated 
— to  read,  if  not  write,  political  literature.  Literacy,  again, 
is  the  significance  of  education.  (Jefferson,  of  course,  knew 
nothing  about  the  I.  Q.  and  supposed  that  intelligence 
was  a  product  of  education. 

But  a  change  is  in  progress.  We  are  now  coming  to  see 
that  if  we  are  really  to  educate  a  people  who  will  be  safe 
for  democracy,  or  for  whom  democracy  will  be  safe,  or  for 
whom  even  religion  will  be  safe,  we  have  got  to  educate  the 
whole  individual.  I  sometimes  think  that  our  schools  are 
intellectual  sweatshops ;  and  then  when  I  look  over  the  pro- 
grams of  some  of  the  schools,  I  think  they  are  intellectual 
delicatessen  shops.  They  should  be  neither.  A  school  should 
—sometime  perhaps  all  of  our  schools  will — realize  Froebel's 
idea  that  a  school  is  a  place  where  children  under  proper 
atmospheric  conditions,  may  grow  in  body,  soul  and  spirit. 
Now,  this  is  what  I  meant  when  I  said  that  this  health 
motif  in  education  must  transform  and  is  transforming  the 
whole  of  education. 

I  am  going  to  say  quite  confidently  that  we  shall  not  get 
very  far  with  our  hopes  of  Health  Education  if  we  do  not 
think  of  it  in  that  organic  way — something  that  is  going 
to  modify,  and  in  a  measure  transform  our  theory  of  all 
education.  If  we  think  of  it  merely  as  something  added  to 
traditional  education,  or  a  .method  by  which  we  can  give 
children  information  and  ideas  about  health,  we  shan't  get 
very  far.  Children  are  the  most  conservative  people  in  the 
world,  and  what  the  custom  is  in  a  school  at  a  given  time 
has  great  effect  upon  what  the  children  do  and  become. 

I  am  hopeful  that  out  of  this  Conference  of  one  hundred 
interested,  earnest  and  practical  workers  we  shall  sift  out 
some  important  conclusions  in  regard  to  Health  Education. 

Dr.  Wood: 

"One  thing  may  I  say  before  introducing  the  next  speaker?  We 
should  keep  in  mind  that  the  most  desperate  movements  for  the  care 
of  children's  health  in  the  last  decade  have  been  made  in  other  coun- 
tries than  our  own,  for  reasons  that  are  entirely  obvious  to  you. 
This  country  has  been  more  favored.  On  the  constructive  and  edu- 
cational side  of  health — the  program  of  Health  Education — I  believe 
that  I  am  correct  when  I  say  that  the  United  States  leads  the  world. 
It  has,  for  various  reasons,  a  great  opportunity  and  a  correspondingly 
great  responsibility.  You  would  be  greatly  impressed  if  you  could 
see  the  letters  that  come  in  increasing  numbers  from  many  quarters 


18 

of  the  globe— 200  or  300  a  week— to  the  Child  Health  Organization 
and  to  other  organizations,  from  the  countries  of  Europe,  from  South 
America,  from  Asia,  from  Canada,  from  the  Orient.  The  evidence 
that  we  have  shows  us  how  deeply  interested  they  are,  and  how  con- 
cerned they  are  with  reference  to  the  importance  of  this  part  of  the 
national  program.  This  is  perhaps  peculiarly  striking  in  the  new, 
struggling  nations  of  world  which  have  been  reassembled  since  the 
war.  I  wish  merely  to  make  this  reference  to  a  very  significant  move- 
ment taking  place,  to  the  very  peculiar  opportunity  which  America 
has  to  give  help,  guidance,  examples,  in  demonstrating  this  great  work. 
The  peculiar  significance  of  this  Conference,  representing  all  parts 
of  the  United  States  as  a  national  conference,  is  its  intention  to 
strive  for  a  program,  not  only  to  affect  our  own  country,  but  directly 
and  indirectly  to  affect  the  work  that  is  being  done  in  the  other 
countries  of  the  world." 

Dr.  Wood  then  introduced  Mr.  Daniel  Chase,  the  Super- 
visor of  Physical  Education  of  the  State  of  New  York. 

Mr.  Chase: 

FRST,  let  me  say  that  my  only  excuse  for  being  here  is 
that  Dr.  Frank  Graves,  our  present  Commissioner  of 
Education,  could  not  come  and  asked  me  to  substitute  for 
him  in  saying  a  word  of  welcome.  I  asked  Dr.  Graves  to 
write  me  a  letter  of  greeting,  which  I  brought  with  me  and 
which  I  now  read : 


To  the  Delegates  in  Attendance  at  the  Conference  on  Health  Educa- 
tion: 

It  gives  me  great  pleasure  to  send  a  word  of  greeting  and  of  wel- 
come in  the  name  of  the  State  Department  of  Education  to  the  doctors, 
teachers,  and  other  experts  in  the  field  of  health  and  of  education. 
I  congratulate  you  upon  assembling  at  Lake  Mohonk,  one  of  the 
beauty  spots  of  our  great  Empire  State,  and  regret  that  I  cannot 
be  with  you  in  person.  It  would  give  me  great  pleasure  to  participate 
in  the  discussion  and  to  get  from  you  some  of  the  information  and 
inspiration  that  is  bound  to  come  from  your  discussion  on  this  most 
vital  question. 

As  it  has  frequently  been  said:  "It  is  only  recently  that  edu- 
cators have  come  to  realize  that  the  physical,  mental  and  moral  nature 
of  a  child  is  represented  in  almost  every  conscious  act,  and  that  the 
'school  is  for  the  whole  child'."  In  its  origin  the  primary  function 
of  the  school  was  mental  training,  learning  from  books  and  teachers. 
Even  yet  some  boards  of  education  and  teachers  see  nothing  in  the 
school  save  a  place  to  learn  facts  from  books,  but  gradually  all  of 
us  are  coming  to  understand  the  interdependence  of  mind  and  body. 
It  is  now  known  that  the  physical  growth  and  well-being  of  a  child 
condition  his  entire  intellectual  life. 


19 

The  Middle  Ages,  with  their  asceticism  and  repression,  held  us 
long  in  their  thrall,  and  less  than  a  century  has  passed  since  we 
completely  abandoned  the  idea  that,  in  order  to  refine  the  mind  and 
rescue  the  soul,  we  must  neglect  the  body  and  mortify  the  flesh. 
But  biology,  psychology  and  common  sense  have  done  their  work, 
and  so  apparent  now  is  the  relationship  that  "even  he  who  runs 
may  read."  Progressive  school  boards  are  getting  to  feel  less  con- 
cerned about  the  possible  ability  of  new  teachers  to  "Discipline" 
(spelled  with  a  big  D)  than  about  their  being  able  to  interpret  the 
infallible  signs  of  fatigue,  failing  vision,  obstructed  hearing,  St. 
Vitus'  Dance,  and  inadequate  nourishment.  We  cannot  yet  say,  "Take 
care  of  the  body  and  the  soul  will  take  care  of  itself,"  but  we  may 
safely  insist  that  all  higher  mental  and  moral  qualities  have  a 
physical  basis,  and  that  if  the  material  is  neglected,  the  spiritual 
cannot  reach  its  highest  development.  We  are  coming  to  see  that 
no  school  which  fails  to  provide  for  the  physical  well-being  can  be 
a  good  school  even  on  the  purely  mental  or  moral  side.  The  school 
must  share  with  the  home  the  task  of  maintaining  the  normal  growth 
and  natural  vigor  of  the  child,  if  it  expects  to  control  his  intellectual 
and  ethical  development. 

I  shall  be  much  interested  to  have  a  full  report  of  the  results  of 
your  deliberation.  I  am  very  happy  to  know  that  the  State  Depart- 
ment of  Education  is  to  be  represented  by  at  least  two  members — 
the  Medical  Inspector  of  Schools  and  the  State  Supervisor  of 
Physical  Education.  These  men  know  what  is  being  done  throughout 
the  State  and  are  well  qualified  to  present  the  viewpoints  of  the 
Department  on  the  matters  under  discussion.  Many  of  our  policies 
have  not  yet  crystallized.  I  hope  that  we  will  always  remain  open- 
minded  enough  to  change  them  when  occasion  demands.  We  are  all 
seekers  after  truth. 

It  is  my  earnest  wish  that  you  may  have  a  successful  conference 
and  a  most  enjoyable  period  of  good  fellowship. 

Sincerely  yours, 

(Signed)   FRANK  P.  GRAVES. 

We  specialists  are  apt  to  be  like  the  "Village  Oracle, 
Dan'l  Hanks."  You  remember: 

Old  Dan'l  Hanks  he  says  this  town 

Is  jest  the  best  on  earth; 
He  says  there  ain't  one,  up  nor  down, 

That's  got  one-half  her  worth ; 
He  says  there  ain't  no  other  State 

That's  good  as  ourn,  nor  near; 
And  all  the  folks  that's  good  and  great 

Is  settled  right  'round  here. 

Says  I,  "D'jer  ever  travel,  Dan?" 

"You  bet  I  ain't!"  says  he; 
"I  tell  you  what!   the  place  I've  got 

Is  good  enough  for  me!" 


20 

Some  fellers  reckon,  more  or  less, 

Before  they  speak  their  mind, 
And   sometimes  calkarlate  or  guess, — 

But  them  ain't  DanTs  kind, 
The  Lord  knows  all  things,  great  or  small, 

With  doubt  He's  never  vexed; 
He,  in  His  wisdom  knows  it  all, — 

But  Dan'l  Hanks  comes  next. 

Says  I,  "How  d'jer  know  you're  right?" 

"How  do  I  know?"  says  he; 
"Well,  now,  I  vum!    I  know,  by  gum! 

I'm  right  because  I  be!" 

Fortunately,  we  are  not  here  in  the  spirit  of  "Dan'l 
Hanks,"  but  rather  to  learn  from  each  other. 

The  value  of  teaching  health  habits  as  a  part  of  physical 
education  is  that  physical  activities — things  that  boys  and 
girls  naturally  do — help  to  make  attractive  the  things  they 
ought  to  know  about  their  physical  natures.  I  maintain  that 
education  through  activities  is  the  big  thing  that  is  going  to 
leaven  the  health  lump.  The  physical  nature,  the  mental 
nature,  and  the  moral  nature  are  all  bound  up  in  one  whole, 
and  as  we  contribute  towards  the  one  we  help  the  other.  We 
must  devise  methods  and  ways  of  working  closely  with  all 
educational  forces  for  better  health  and  better  character  of 
our  future  citizens. 

In  the  past  five  years,  28  States  have  passed  legislation 
looking  to  compulsory  physical  education  and  physical  train- 
ing for  school  children.  England,  France  and  the  other 
countries  of  Europe  have  similar  work  on  foot.  Our  prob- 
lem is  very  much  like  that  of  Great  Britain,  ,as  a  recent 
letter  from  the  Director  of  Physical  Education  at  Glasgow, 
Scotland,  shows,  in  which  he  says : 

Those  of  us  engaged  in  physical  education  in  Britain  feel  it  neces- 
sary at  present  to  place  emphasis  upon  the  educational  value  of 
physical  training.  The  hygienic  and  corrective  values  are  now  more 
readily  recognized  and  appreciated.  In  the  past,  physical  training 
has  largely  rested  upon  military  ideals  and  much  of  its  technique 
followed  the  military  pattern.  This  ideal  is  passing,  giving  place  to 
an  educational  ideal.  Success  can  only  come  by  recognizing  that  the 
maintenance  of  health  and  the  development  of  an  active  personality 
are  fundamental  problems  of  education  in  general,  and  that  physical 
education  must  therefore  be  woven  into  the  weft  and  warp  of  the 
whole  educational  process.  The  horizon  of  physical  education  must 
be  widened — and  it  is  being  widened.  Until  comparatively  recently 
its  means  have  consisted  almost  entirely  of  formal  physical  drills 


21 

and  gymnastics  on  the  one  hand  and  games  on  the  other — all  valu- 
able for  health  and  character  but  regarded  as  something  apart  from 
or  outside  the  purview  of  the  educationist.  The  educationist 
must  realize  that  physical  education  is  not  merely  a  matter  of  health 
training,  but  that  it  is  a  method  and  process  of  educating  the  child 
through  physical  channels  as  distinct  from  other  channels  which 
are  almost  purely  mental,  reflective  and  contemplative.  Perhaps  up 
to  the  age  of  14,  or  even  later,  most  education  is  acquired  through 
purely  physical  channels. 

In  the  same  way  that  the  teaching  of  English  is  not  the  sub- 
stance of  a  single  subject  of  the  curriculum,  but  can  be  taught  dur- 
ing every  moment  of  contact  between  teacher  and  child,  so  physical 
education  is  not  the  substance  of  a  special  part  of  the  school  time- 
table devoted  to  gymnastics  or  games,  but  should  permeate  the  entire 
curriculum  and  the  whole  school  environment.  Education  must  have 
not  only  high  intellectual  ideals,  but  high  physical  ideals.  Class 
teachers  must  approach  education  from  physical  as  well  as  from 
intellectual  angles,  and  if  education  in  the  past  has  failed  through 
exclusive  attention  to  mind,  we  physical  trainers  must  see  to  it  that 
physical  education  does  not  fail  through  exclusive  attention  to 
body.  Those  responsible  for  physical  education  must  be  fully  ac- 
quainted with  education  in  general — its  history,  its  philosophy  and 
ideals — in  order  to  estimate  correctly  the  value  and  position  of 
physical  training  in  the  whole  fabric  of  education. 

New  York  State  is  glad  you  are  here,  and  we  hope  to 
gain  from  your  wisdom  much  that  will  help  us  all. 

Upon  the  conclusion  of  Mr.  Chase's  welcome,  Dr.  Wood 
closed  the  opening  session.  In  so  doing,  he  extended  to  the 
guests  the  cordial  greetings  of  Mrs.  Smiley,  who,  as  hostess 
of  this  great  mountain  resort,  had  put  the  delightful  facili- 
ties of  the  hotel  and  its  beautiful  grounds  so  fully  at  the 
disposal  of  the  Conference. 

Following  the  addresses  came  the  opportunity  for  mem- 
bers of  the  Conference  to  become  acquainted,  and  to  make 
some  plans  for  enjoying  together  the  recreational  possibili- 
ties of  Lake  Mohonk.  This  increased  the  atmosphere  of 
sympathetic  receptivity  to  each  other's  point  of  view — 
which  was  so  large  a  factor  in  the  free  and  friendly  discus- 
sions that  characterized  this  Conference,  and  contributed 
no  little  to  its  success. 


Section  II 

SUBJECT  MATTER  IN  HEALTH  EDUCATION 

TO  aid  the  Conference  members  to  organize  in  their  own 
minds  the  contributions  of  so  varied  a  company,  the 
Program  Committee  grouped  the  discussions  around 
three  main  questions,  namely — the  "What"  of  Health  Edu- 
cation, the  "Where"  and  the  "How."  It  was  believed  that 
after  such  a  well  ordered  consideration  of  the  constituent 
elements  in  a  school  program,  the  general  outline  of  the  kind 
of  teacher-training  required  would  emerge.  It  was  in  line 
with  this  plan  that  the  first  working  session  of  the  Confer- 
ence was  given  to  "Subject  Matter."  Dr.  C.-E.  A.  Winslow, 
Professor  of  Public  Health,  Yale  University  School  of  Medi- 
cine, presented  the  first  paper: 

The  Objectives  and  Content  of  Formal  Instruction 
in  Hygiene 

PERSONAL  hygiene  has  changed  the  habits  of  daily  life. 
The  modern  public  health  movement  is  definitely  a 
movement  f or  bettering  the  Jiealth  conditions  oJLthe  com- 
munity^whicH  of  course  depend  upon  the  health  of  the 
individual.  We  must  teach  personal  hygiene,  and  in  this 
modern  phase  of  personal  hygiene  we  have  had  to  intro- 
duce entirely  new  methods.  The  public  health  nurse  found 
that  people  did  not  understand  the  things  she  taught  them, 
because  they  had  had  no  training.  Gradually  and  slowly 
we  realized  that  if  we  were  going  to  attain  the  ideals-0f 
health  we  must  £Q_  back  into  the  schools  and  teach  them 
sometMng  about  hygiene. 

After  this  long  journey,  we  went  to  the  little  Red  School 
House  to  see  what  was  being  done  there  for  the  public  health 
campaign.  We  found  that  Health  Education  must  be  revo- 
lutionized in  the  schools. 

Dr.  Holt  told  of  the  origin  of  the  Child  Health  Organiza- 
tion last  night.  The  Child  Health  Organization  had  great 
vision  and  did  a  great  thing  when  it  saw  the  ideal  of  chang- 
ing the  spirit  and  method  of  teaching  health ;  it  was  a  very 

(22) 


23 

courageous  and  very  constructive  idea.  The  splendid  readi- 
ness with  which  the  United  States  Bureau  of  Education 
met  this  issue  and  joined  its  great  moral  forces  with  those 
of  the  Child  Health  Organization  generously  and  in  the 
most  whole-souled  way  must  never  be  forgotten. 

Dr.  Holt  was  very  modest  in  what  he  said  about  what 
has  already  been  achieved.  The  only  way  to  really  get  some 
idea  of  what  has  been  accomplished  is  to  get  the  leaders 
of  the  movement  separately:  Get  Dr.  Holt  to  talk  about 
Miss  Jean  and  Miss  Jean- to  talk  about  Dr.  Holt. 

Hygienejs  now  the  fashionable  thing.  It  is  not  always 
going  to  have  such  a  lead  as  at  the  present  moment.  We 
must  make  the  most  of  it,  so  that  it  will  go  on  when  there 
is  not  the  type  of  striking  leadership  available  as  there  is 
at  present. 

We  progress  in  all  human  undertaking  by  oscillations 
between  one  extreme  and  the  other — a  principle  which  is 
admirably  illustrated  in  the  history  of  the  teaching  of 
hygiene.  Ten  years  ago,  where  such  teaching  existed  at  all, 
it  involved  chiefly  the  memorizing  of  the  names  of  the  bones 
of  the  human  body  and  similar  mental  gymnastics  of  a 
character  as  futile  as  any  that  has  ever  been  perpetrated 
in  the  name  of  education.  /Today  we  are  in  the  flood  of  a 
wholesome  reaction  against  such  teaching  of  unimportant 
and  disconnected  facts.  'The  motive  of  the  t\me  is  habit 
formation;  and  largely  through  the  stimulus  of  the  Child 
Health  Organization  of  America  we  have  developed  a  whole 
host  of  devices  for  making  Health  Education  vital  and  com- 
pelling. The  basis  of  our  present  attack  is  the  height  and 
weight  chart  with  its  direct  appeal  to  the  competitive  in- 
stinct, and  grouped  about  this  fundamental  device  we  have 
a  whole  technique  of  health  stories,  health  poems,  health 
plays,  health  clowns  and  health  fairies  to  aid  in  seizing  the 
imagination  of  the  child  and  enlisting  his  interest  in  the 
new  movement. 

All  this  is  admirable,  but  I  suspect  that  we  shall  soon 
face  a  real  danger  of  swinging  the  pendulum  too  far.  Habit 
formation  should  no  doubt  be  our  first  aim,  but  it  is  by  no 
means  our  only  aim.  We  must  also  lay  a  sound  basis  of 
knowledge  if  the  child  is  to  be  something  more  than  an 
automaton — if  it  is  not  only  to  learn  certain  tricks,  but  is 
also  to  acquire  intelligence  which  will  enable  it  to  modify 
its  habits  to  meet  the  changing  conditions  of  its  after  life. 


Two 
Funda- 
mentals of 
Health 
Teaching. 


The  Need 
for  Organi- 
zation. 


24 


With  every  year  health  problems  loom  larger  in  our  com- 
munity life,  and  if  the  citizen  is  to  deal  competently  with 
such  problems  he  must  know  something  more  than  that 
he  was  taught  in  school  to  brush  his  hair  in  the  morning, 
to  operate  the  tooth  brush  with  a  rotary  motion,  to  eat 
carrots  and  drink  milk.  I  believe  then  we  may  advance  as 
a  fundamental  postulate  that  a/ program  of  school  hygiene 
should  include  not  merely  the  formation  of  health  habits 
immediately  necessary  to  the  child,  but  also  the  acquisition 
of  a  certain  basic  body  of  knowledge  which  will  be  neces- 
sary for  the  continuance  of  healthy  living  in  the  future. 
In  the  words  of  the  committee  on  a  school  health  program 
of  the  American  Public  Health  Association:  "The  goals 
of  health  instruction  are  to  establish  health  habits,  to  give 
the  child  the  practical  knowledge  of  the  principles  of  health- 
ful living,  to  develop  health  ideals,  to  arouse  a  sense  of  indi- 
vidual responsibility  for  the  health  of  the  community,  and 
community  responsibility  for  the  health  of  the  individual/' 
In  the  second  place,  it  seems  to  me  very  clear  that  the 
inculcation  of  a  necessary  knowledge  of  the  fundamental 
principles  of  healthy  living  requires  a  certain  amount  of 
formal  systematic  instruction  in  a  classroom.  I  know  that 
many  members  of  this  audience  will  rise  up  at  once  and  tell 
me  that  the  most  effective  teaching  of  hygiene  is  being 
accomplished  today  in  certain  schools  where  no  textbooks 
are  used  and  no  formal  period  set  aside  for  the  study  of  this 
subject.  Hygiene  permeates  the  whole  school  curriculum  as 
an  intangible  but  ever-present  influence.  I  acknowledge  the 
fact  but  I  deny  that  it  is  a  fact  upon  which  we  may  safely 
base  general  deductions.  Professor  Thorndike  once  re- 
marked to  me  that  all  educational  experiments  succeed,  and 
it  is  perfectly  obvious  that  in  a  dozen  school  systems  in  the 
United  States  geniuses  have  arisen  who  are  accomplishing 
marvelous  results  by  extra-curricular  inspirational  meth- 
ods. I  submit,  however,  that  it  is  absolutely  out  of  the  ques- 
tion to  expect  that  any  large  proportion  of  the  vast  number 
of  teachers  in  the  public  schools  of  the  United  States  can 
ever  be  transformed  into  inspired  enthusiasts  for  hygiene. 
The  prophet  leads  the  way,  but  educational  reforms,  like 
religions,  must  be  systematized  and  organized  if  they  are 
to  become  practical  forces  in  everyday  life,  even  if  they  lose 
some  of  their  primary  inspiration  in  the  process.  The 
average  teacher  in  the  average  school  will  never  teach 


25 

hygiene  until  there  are  hours  set  apart  for  the  subject, 
until  she  is  graded  and  promoted  by  her  work  in  hygiene 
as  in  other  subjects  and  until  she  is  trained  in  hygiene  in 
a  Normal  School  as  she  is  trained  in  arithmetic  or  English 
grammar  today.    I  would  not  give  up  one  whit  of  what  has 
been  accomplished  in  emphasis  on  habit  formation  and  in  Theplace 
the  development  of  extra-curricular  methods  of  appealing  of  Formal 
to  the  imagination  and  the  will  of  the  child,  but  in  the  long  i™g%$ 
run  such  appeals  will  only  have  their  maximum  effect  if  Teaching. 
they  are  correlated  with  definite  and  formal  instruction  in 
a  subject  which  is  so  essential  to  the  sound  conduct  of  the 
individual  life. 

The  proper  combination  of  systematic  and  incidental 
teaching  of  hygiene  is  well  stated  in  the  admirable  outline 
issued  this  spring  in  mimeograph  form  by  the  Health  Edu- 
cation Bureau  of  the  Department  of  Public  Instruction  of 
the  Commonwealth  of  Pennsylvania.  We  shall  probably 
all  agree  that  "Hygiene  is  best  taught,  not  simply  by  a 
specified  period  of  the  day  devoted  to  formal  health  in- 
struction, but  by  making  it  part  of  the  instruction  in  all 
other  subjects.  In  the  Elementary  Schools  the  health  work 
is  in  most  cases  in  the  hands  of  the  grade  teacher,  who 
should  use  every  opportunity  to  make  reasonable  application 
of  any  fact  or  principle  which  may  arise  in  connection  with 
any  subject  to  the  problem  of  healthful  living.  This  appli- 
cation should  be  made  at  the  time  the  occasion  arises.  In 
this  way  all  other  subjects  may  be  made  to  support  health 
instruction.  In  the  lower  grades  there  is  little  place  for 
systematic  class  instruction."  We  must  also,  however,  I 
think,  agree  with  the  succeeding  sentences,  which  might  per- 
haps even  be  stated  somewhat  more  strongly — "but  in  the 
upper  grades  it  (systematic  class  instruction)  may  be  very 
valuable  if  it  is  used  to  support  health  habits  which  have 
been  or  are  being  acquired,  and  to  develop  in  the  pupils  a 
definite  sense  of  responsibility  for  community  as  well  as 
personal  health.  The  social  approach  is  always  better  than 
the  personal." 

The  exact  stage  of  school  life  at  which  formal  systematic 
instruction  should  begin  is  still  to  some  extent  a  debatable 
problem.  The  excellent  Pennsylvania  outline  contemplates 
the  introduction  of  such  instruction  (with  the  use  of  text- 
books) in  the  fifth  grade.  Of  15  States  whose  hygiene 
programs  happen  to  be  accessible  to  me  as  I  write,  7  pro- 


26 


The  Time 
to  Begin 
Formal 
Instruction. 


A  Biologi- 
cal View- 
point in 
Health 
Teaching 
Essential. 


vide  for  the  use  of  textbooks  in  the  fourth  grade,  4  in  the 
fifth  grade,  3  in  the  sixth  grade  and  1  in  the  eighth  grade. 

I  myself  am  inclined  to  believe  that  the  fourth  grade 
is  not  too  early  a  point  for  the  commencement  of  formal 
instruction  in  the  elements  of  hygiene.  The  committee  on 
school  programs  of  the  American  Public  Health  Association, 
on  the  other  hand,  believes  that  "in  the  Kindergarten  and 
four  lower  grades  the  chief  effort  should  be  to  develop 
health  habits  mainly  by  inspections  and  special  devices.  In 
subsequent  grades  systematic  instruction  should  attempt  to 
crystallize  and  fix  the  health  habits  which  have  been  taught 
heretofore,  and  to  provide  the  pupil  with  necessary  infor- 
mation concerning  the  physical  basis  for  healthful  living, 
principles  of  bacteriological  cleanliness,  and  the  sanitation 
of  the  community." 

The  majority  of  experts  in  this  subject  will,  I  think, 
agree  that  either  in  the  fourth  or  fifth  grade  formal  health 
instruction  should  begin;  and  on  this  assumption  I  should 
like  to  outline  what  seem  to  me  a  few  of  the  broad  and 
fundamental  elements  of  knowledge  which  such  instruction 
should  inculcate. 

First  of  all,  and  most  important,  is  the  basic  conception 
of  the  body  as  a  living  machine,  working  in  accordance  with 
physical  and  chemical  laws,  and  working  as  a  coordinating 
whole  with  the  health  of  each  part  depending  on  the  normal 
functioning  of  the  rest.  It  is  essential  that  this  conception 
should  be  grasped,  not  as  a  form  of  words,  but  as  a  solid 
and  vital  basis  of  all  the  student's  thinking  about  health. 
If  such  a  view  were  really  held  as  a  basic  conviction  by  our 
adult  citizenry,  it  is  probable  that  four-fifths  of  the  delu- 
sions and  superstitions  and  quackeries  that  weigh  upon  the 
human  race  would  vanish  like  a  dream.  The  development 
of  this  fundamental  viewpoint  depends,  of  course,  on  other, 
types  of  instruction  than  that  given  in  hygiene.  It  is  rooted 
and  grounded  in  a  knowledge  of  general  biology.^  As  Presi- 
dent R.  L.  Wilbur  of  Stanford  University  wrote  me  a  few 
weeks  ago  in  connection  with  the  program  of  this  .Con- 
ference: "I  feel  that  there  should  be  particular  emphasis 
laid  upon  biological  work — nature  study,  zoology,  botany 
etc.,  as  a  basis  for  thinking  in  terms  of  life.  Otherwise 
hygiene  is  too  apt  to  be  a  series  of  more  or  less  true  so 
called  'precepts.'  My  feeling  is  that  sound  and  universa 
training  in  biology  for  our  college  population  would  sooi 


27 

give  us  the  teachers  to  handle  hygiene  in  the  schools  and 
a  proportion  of  citizens  with  an  appreciation  of  hygiene  in 
ordinary  life.  The  teachers  need  to  think  biologically  more 
than  to  put  over  rules." 

If  we  could  really  inculcate  this  conception  of  the  living 
machine  with  all  that  it  implies  I  should  be  almost  satisfied 
with  the  accomplishment  of  the  course  in  hygiene.    It  is   Six 
impossible,  however,  to  teach  this  general  lesson — except  important 
as  a  form  of  words — without  a  sufficiently  detailed  exposi-  ^flpj^_8 
tion  of  physiology  to  make  its  meaning  a  vital  element  in   ology. 
intellectual  experience;  and  there  are  a  number  of  sub- 
ordinate principles  in  the  working  of  the  living  machine 
of  sufficient  moment  to  make  their  inclusion  in  our  course 
essential  to  its  adequacy.     Among  such  I  would  call  par- 
ticular attention  to  the  following,  always  remembering  in 
the  words  of  the  Pennsylvania  outline  cited  above,  that  "only 
so  much  formal  information  should  be  given  as  will  render 
possible  good  health  in  the  parts  described" : 


(1)  It  is  not  important  to  know  the  number  and  the  names 
of  all  the  bones,  but  it  is  essential  to  know  something  of  the 
structure   and  inter-relations  of  the  parts  of  the  bony   system 
and  to  understand  the  structure  and  the  general  arrangement 
of  the  muscles  if  the  child  is  to  have  an  intelligent  grasp  of  what 
is  involved  in  correct  posture,  if  it  is  to  comprehend  the  real 
value  of  exercise  and  if  in  future  life  it  is  to  respond  intelligently 
to  the  professional  advice  of  the  orthopedist. 

(2)  A  knowledge  of  the  mechanics  and  the  chemistry  of  diges- 
tion is  vital  to  the  continued  maintenance  of  sound  elementary 
habits  and  only  a  real  knowledge  of  the  elements  of  nutrition 
will  make  possible  a  judicious  appraisement  of  the  dietary  fads 
and  fancies  with  which  the  citizen  of  the  future  is  likely  to  be 
confronted  in  increasing  degree.     Under  the  general  heading  of 
the  digestive   system  we  may  also  mention  the  importance   of 
some  conception  of  the  structure  of  the  teeth  and  of  the  process 
of   dental   disease  which  will   facilitate   a  future  utilization  of 
the  resources  of  dental  hygiene. 

(3)  A  clear  comprehension  of  the  physics  of  the  circulation 
is  basically  important  for  any  conception  of  the  effects  of  the 
atmospheric  envelope  upon  the  body  and  for  a  rational  control 
of  the  effects  of  this  atmospheric  envelope  through  ventilation 
and  clothing. 

(4)  A  knowledge  of  the  ways  in  which  wastes  are  eliminated 
from  the  body  is  fundamental  in  avoiding  constipation  and  in 
maintaining  the  kidneys  in  a  healthy  condition.     Here,  as  in  the 
case  of  the  circulation,  it  is  through  a  real  knowledge  of  the 
machinery  involved  that  the  individual  will  be  disposed  to  take 


28 


The 

Knowledge 

Essential 

for  the 

Promotion 

of  Public 

Health. 


the  fullest  advantage  of  medical  counsel  bearing  on  the  post- 
ponement of  the  degenerative  diseases  of  later  life. 

(5)  A  vital  conception  of  the  structure  of  the  nervous  system 
furnishes  the  only  sound  basis  for  intelligent  mental  hygiene, 
for  habit  formation,  rather  than  the  learning  of  tricks  like  a 
pet  dog,  and  for  the  adjustment  of  work  and  rest  so  as  to  insure 
a  maximum  of  productive  performance.     The  practical  hygiene 
of  the  eye  and  ear  requires  an  intelligent  comprehension  of  the 
structure  of  these  complex  but  frequently  defective  appendages 
of  the  central  nervous  system. 

(6)  Finally,  under  the  general  head  of  physiology,  the  pupil 
should  be  given  an  elementary  view  of  the  cyclical  changes  in 
the  human  body,  of  the  ways  in  which  developmental  and  degen- 
erative diseases  arise  and  of  the  possibilities  of  medical  science 
as   applied   to   the   early   detection    and   hygienic   treatment   of 
incipient  disease. 

In  addition  to  these  points,  which  appear  to  me  to  con- 
stitute the  most  essential  elements  in  a  sound  knowledge  of 
physiology  proper,  the  pupil  should  also  be  equipped  with  an 
equally  sound  comprehension  of  those  fundamental  relations 
between  man  and  his  microbic  and  other  enemies  which 
underlie  the  control  of  the  environmental  diseases.  In  this 
field,  again,  there  are  half  a  dozen  outstanding  points  which 
deserve  special  mention : 

(1)  The  expansion  of  everyday  conceptions  of  cleanness,  to 
include  the  vitally   important   sorts   of   cleanness   can   only   be 
acquired  through  knowledge   of  the  principles  of  bacteriology, 
best  by  actual  demonstrations  of  cultures  which  the  student  can 
see  and  handle.     Much  of  the  inspirational  health  teaching  of 
the  present  day  shows  that  even  the  would-be  teacher  of  hygiene 
has  quite  failed  to  grasp  the  essential  distinction  between  dirt 
which  is  dangerous  and  dirt  which  is  merely  unsightly. 

(2)  In  the  second  place,  the  distinction  between  the  harmful 
and  the  harmless  bacteria  should  be  made  clear,  with  the  fact 
that  the  dangerous  types  have  their  origin  only  in  the  human 
and  animal  body;  so  that  a  vague  fear  of  dirt  and  disease  in  the 
abstract  may  be  replaced  by  an  intelligent  sanitary  conscience 
which  will  facilitate  the  isolation  of  disease  in  its  early  stages. 

(3)  Thirdly,  the  pupil  should  be  given  a  conception  of  the 
way  in  which  disease  germs  are  transferred  from  one  person  to 
another  by  water  and  other  articles  of  food  and  particularly 
by  insects;  and  of  the  methods  of  preventing  such  transfer  by 
measures  of  public  sanitation.     The  control  of  the  fly  nuisance 
offers  a  peculiarly  valuable  direct  contact  with  personal  experi 
ence  in  this  field. 

(4)  Next  in  importance  is   a   comprehension  of  the  natur< 
of  the  struggle  between  the  invading  microbe  and  the  humai 
host  with  an  intelligent  grasp  of  the  principles  of  vaccine  an> 
serum  therapy,  which  promise  to  play  an  ever-increasing  rol 


29 

in  the  control  of  communicable  disease.  With  instruction  of 
this  sort  the  obstructive  efforts  of  the  anti-vaccinationist  would 
lose  their  power  and  smallpox,  typhoid  and  diphtheria  could 
be  brought  under  complete  control. 

(5)  In    the   higher    grades    the    principles    involved    in   the 
control  of  tuberculosis  and  infant  mortality  should  find  a  place. 
In  these  and  other  fields  an  intelligent  cooperation  of  the  citizen 
is  vital  to  success  and  that  cooperation  can  only  be  secured  in  a 
community  where  the  elementary  principles  involved  are  under- 
stood. 

(6)  If  the  citizen  is  to  play  his  part  in  the  broader  community 
struggle  against  preventable  disease  he  should  understand  some- 
thing of  the  main  objectives  and  the  general  activities  of  the 
health  departments  of  city,  state  and  nation.     The  health  officer 
who  operates  in  a  community  where  any  substantial  proportion 
of  the  citizens  have  received   a  basic   instruction  of  this  kind 
would  be  able  to  accomplish  results  in  the  saving  of  lives  of 
which  we  have  scarcely  dreamed  in  the  philosophy  of  the  past. 

(7)  Finally,  we  should  recognize  a  growing  and  a  very  sound 
tendency  to  introduce  into  the  school  curriculum  well  planned   "Safety 
instruction  in  regard  to  safety  in  the  street  and  in  the  home.    First." 
One-half  of  the  victims  of  automobile  accidents  are  children,  of 

whom  over  500  are  killed  and  12,000  injured  in  New  York  City 
every  year.  The  schools  of  St.  Louis  reduced  fatal  accidents  of 
school  children  by  more  than  60  per  cent,  through  intensive 
safety  teaching.  The  Safety  Institute  of  America  is  planning 
to  furnish  a  special  information  service  for  the  teachers  of  the 
city  along  this  line  next  year. 

Without  the  acquisition  of  such  broad  elements  of 
knowledge  as  those  outlined  above,  our  scheme  of  Health 
Education  will  fall  short  of  the  attainment  of  its  highest 
possibilities.  Let  us  continue  to  emphasize  the  acquisition 
of  health  habits  as  the  primary  aim  of  such  education ;  but 
let  us  base  these  habits  and  their  modification  in  the  coming 
years  upon  a  sound  knowledge  of  the  underlying  principles 
of  physiology  and  hygiene.  Let  us  utilize  all  the  resources 
of  correlation  and  extra-curricular  inspirational  technique ; 
but  let  us  provide  also  for  such  systematic  formal  instruc- 
tion as  can  alone  ensure  for  hygiene  its  definite  and  perma- 
nent place  in  our  educational  system. 

Discussion 


The  discussion  was  opened  by  Professor  C.  D.  Hart,  Col- 
lege of  William  and  Mary,  Williamsburg,  Va.  Professor 
Hart  said : 

"We  all  know  that  education  in  health  must  start  in  early  life. 
Perhaps  the  ideal  is  the  pre-school  age. 


30 

"Personally  when  it  comes  to  the  program  it  seems  to  me:  the 
first  four  years,  health  habits;  the,  next  two  years  (on  the  basis  of 
Elementary  School  and  Junior  High),  physiology  of  the  body,  a  knowl- 
edge of  the  subject  matter  of  physiology;  the  next  year,  home 
hygiene;  the  next  year,  community  hygiene.  A  large  percentage 
of  students  go  only  to  the  eighth  and  ninth  grades.  We  must  there- 
fore give  all  the  subject  matter  that  we  want  to  get  over  in  funda- 
mentals in  that  number  of  years. 

"I  believe  the  first  thing  this  Conference  must  settle  is  how  many 
years  we  are  to  teach  hygiene — that  is,  give  formal  instruction.  Then, 
what  are  we  going  to  teach  in  each  year?  We  can  say  this  must  be 
done  in  nine  years,  but  we  must  know  when  it  is  to  be  done  and  what 
our  standard  of  attainment  must  be  in  each  year.  It  seems  to  me 
that,  after  the  health  habits,  we  must  start  in  with  formal  instruction 
in  the  5th  grade,  but  also  review  health  habits.  The  only  way  to 
get  it  over  is  to  devote  at  least  20  minutes  a  week  to  the  subject. 
The  enthusiastic  teacher  attempts  to  coordinate  it  in  all  her  subjects. 

"For  the  last  two  years  I  have  corresponded  with  over  a  thousand 
teachers  and  I  have  found  that  they  do  not  know  the  least  thing 
about  subject  matter.  How  can  you  expect  them  to  coordinate  at 
the  present  time,  until  laws  are  passed  requiring  them  to  know  a 
certain  amount?  If  you  give  the  teacher  that  has  not  been  trained 
a  textbook  and  outline,  you  can  expect  so  much  to  be  put  over  but 
you  cannot  expect  coordination  until  you  can  get  that  teacher  enthused 
by  all  kinds  of  activities." 


Dr.  Wood,  at  this  point,  called  the  attention  of  the 
ference  to  the  importance  of  confining  the  discussion  to  sub- 
Some  Valid  ject  matter — and  indicated  the  need  to  find  valid  organ- 
pSsZin9  izin&  Points  with  reference  to  which  the  field  of  subject 
SWecZ         matter  indicated  by  the  speakers  could  be  defined,  so  as  to 
meet  the  minimum  requirement  of  the  ideal  program  the 
Conference  had  in  mind. 

Organizing  points  useful  for  such  selection  of  subject 
matter,  were  offered. 

Dr.  Small  suggested  the  habit  and  conduct  of  life  desired 
of  people,  saying: 

"I  am  glad  to  agree  with  Dr.  Winslow  that  we  have  to  have 
knowledge,  and  that  irrational  habit  won't  get  us  very  far.  I  want 
to  call  your  attention  to  the  fact  that  after  all  it  is  habit,  or  conduct 
of  life,  that  we  are  aiming  at,  and  that  the  knowledge  is  merely 
subservient  to  that. 

"Let  us  remember  that  Matthew  Arnold  was  right  when  he  said 
that  conduct  is  three-fourths  of  life,  and  that  is  what  we  are  aiming 
at.  We  want  this  morning  to  find  out  what  knowledge  is  necessary 
to  ensure  reasonable  conduct. 

"I  call  your  attention  to  the  fact  that  it  is  the  conduct  of  all 
of  the  people.  Not  the  conduct  of  those  who  sit  around  a  Conference 


31 

like  this — not  the  conduct  of  those  who  go  to  college — but  the  conduct 
of  all  the  people.  And  we  have  got  to  realize  that  the  grade  of 
intelligence  of  all  the  people  is  something  that  is  not  affected  very 
much  by  the  amount  of  instruction,  the  amount  of  knowledge,  that 
we  feed  out  to  them — it  is  an  inherent  thing.  I  do  not  assume 
that  we  can  grade  all  children  by  a  mental  test. 

"In  our  dealings  with  the  problem  of  Health  Education  or  education 
in  health,  we  must  keep  in  mind  that  75  per  cent,  or  80  per  cent, 
of  the  people  have  a  rather  moderate  grade  of  intelligence,  and  if 
we  are  going  to  think  in  terms  of  educating  or  training  all  the 
people  so  that  they  will  have  a  reasonable  understanding  of  what 
public  health  demands  of  them,  we  must  work  out  a  rather  limited  pro- 
gram and  must  realize  that  there  are  several  grades  of  conduct — a 
grade  for  all  of  the  children  in  the  lower  elementary  grades — a  differ- 
ent thing  for  the  upper  elementary  grades,  not  only  different  in  quan- 
tity but  different  in  quality. 

"One  other  point  I  want  to  make  is  that  after  all  effective  knowl- 
edge comes  through  performance,  and  I  hope  that  we  are  not  going  to 
fool  ourselves  with  the  idea  that  getting  knowledge — whether  out  of 
books,  lectures,  motion  picture  reels,  or  laboratories  is  all.  If  it  is 
merely  the  passive  reception  of  knowledge  that  we  feed  into  children  in 
the  elementary  grades  we  are  not  going  to  get  far.  We  have  got 
to  have  the  knowledge  that  comes  from  the  activities  of  children." 

Miss  Emma  Dolfinger,  Associate  Director  of  the  Child   The"Rules 
Health    Organization,    added,    in    line    with    Dr.    Small's  ^a^»  as 
thought,  that  in  the  "Rules  of  the  Game,"  we  had  very  Organizing 
pertinent  organizing  points,  for  practically  all  subject  mat-  Pomts- 
ter  needed  in  elementary  schools. 

Mr.  A.  L.  Safford,  Superintendent  of  Schools,  Reading, 
Mass.,  stated  that  children's  activities  and  interests  were 
important  organizing  foci. 

Dr.  Walter  Brown,  of  the  Mansfield  Child  Health  Dem- 
onstration, stated  the  importance,  as  an  organizing  point, 
of  the  scientific  knowledge  required  of  people  for  intelligent 
cooperation  with  public  health  workers.  He  specially 
stressed  this,  in  the  selection  of  subject  matter  for  teachers' 
courses. 

Mrs.  Lucy  M.  Paul,  Instructor  in  Physiology,  Bacteri- 
ology and  Hygiene,  Pratt  Institute,  Brooklyn,  referring 
back  to  Dr.  Winslow's  suggested  outline  of  subject  matter, 
said: 

"A  very  practical  thing  and  a  very  desirable  one  to  get  into  public 
school  work  is  action  in  emergencies.  It  should  be  given  in  such  a 
way  that  the  child  should  be  able  to  take  care  of  such  things,  as  a 
cut  and  how  to  tie  it  up,  etc.  There  is  a  place  for  emergencies 
along  with  home  hygiene." 


32 


Conserva- 
tion of 
Vision. 


Mrs.  Isabelle  W.  Baker,  of  the  American  Red  Cross, 
Washington,  D.  C.,  added: 

"First  aid,  as  given  in  the  home  hygiene  course  as  outlined  by 
the  A.  R.  C.  is  more  practical  than  the  Red  Cross  first  aid  course, 
which  is  more  technical.  First  aid  in  the  home  hygiene  course  is 
taught  under  our  direction  with  home  appliances." 

Miss  Jean  said: 

"This  talk  makes  me  think  of  a  large  group  of  public  schools. 
In  one  of  these  schools  there  were  1,000  children.  It  was  quite  im- 
practical for  the  nurse  in  charge  to  give  the  care  required  in 
emergencies,  so  they  organized  a  group  of  children  from  the  5th, 
6th,  7th  and  8th  grades,  to  assist,  and  it  was  not  only  possible,  but 
most  enthusiastically  received  by  the  children,  who  acted  as  assistants, 
to  learn  to  apply  a  bandage  easily.  It  is  quite  possible  for  a  normal 
5th  grade  child  to  be  able  to  use  common  sense  and  meet  emergencies, 
and  arrange  a  bandage  as  well  as  the  nurse,  and  to  have  some 
general  idea  of  asepsis. 

"This  plan  has  also  been  worked  out  in  playgrounds,  where 
organized  health  work  is  very  necessary.  Every  "Leader"  had  a 
thorough  course  in  first  aid  work  during  the  winter  as  part  of  her 
training,  and  she  applied  it  in  emergencies  during  the  summer.  As 
a  result  girls  with  no  technical  training  in  health  cared  for  most 
injuries.  It  seems  of  utmost  importance  and  should  be  included  in 
every  well-developed  school  system." 

Mr.  Lewis  H.  Carris  asked  the  privilege  of  presenting 
another  important  claimant  for  inclusion  in  the  subject 
matter  of  a  Health  Education  program.  He  said : 

"I  am  the  Field  Secretary  of  the  National  Committee  for  the 
Prevention  of  Blindness  and  the  Conservation  of  Vision.  The  Na- 
tional Committee  for  the  Prevention  of  Blindness  originally  started 
out  to  try  to  eradicate  some  of  the  most  obvious  cases  of  total  blind- 
ness, and  it  found  itself  soon  involved  in  the  broad  program  of  the 
conservation  of  vision.  The  National  Committee's  work  fits  into  and 
emphasizes  and  gives  effect  to  such  a  program  as  this,  which  we 
are  considering  here  this  week — the  matter  of  helping  children  to 
be  healthy.  The  National  Committee  really  serves  as  a  professional 
organization  through  its  employes,  in  going  into  all  fields  of  science, 
particularly  the  practice  and  science  of  medicine  and  getting  out  from 
the  best  practice  and  the  best  writings  the  things  which  concern  the 
conservation  of  vision. 

"I  think  the  people  in  general  do  not  yet  realize  the  importance 
of  the  preservation  of  good  vision.  I  may  be  saying  something 
which  I  won't  be  able  to  say  in  two  or  three  years,  but  as  I  see 
it  now,  I  am  inclined  to  believe  that  the  question  of  vision  is  almost 
as  important  as  the  question  of  nutrition,  which  has  been  discussed 
so  much  here  this  week.  It  is  a  fact  that  the  eye  is  one  of  the  most 
important  parts  of  the  human  machine.  It  is  a  fact  that  we  now 
bring  children  into  our  schools,  under  our  compulsory  education  laws, 


33 

to  sit  under  conditions  which  involve  a  considerable  amount  of  eye- 
strain.  The  modern  work  of  studying  and  reading  from  books  is 
not  the  kind  of  work  which  the  eye  is  built  to  do.  Consequently, 
all  the  children  who  are  in  our  schools  are  subjected  to  eye-strain. 
Conservation  of  vision  is  on  the  positive  side.  No  teacher  wants  a 
child  in  her  classes  to  get  such  defective  vision  that  glasses  are 
necessary.  It  is  true,  however,  that  a  considerable  percentage  of 
eyes  are  defective  to  such  an  extent  that  glasses  are  necessary. 

"We  have  to  consider  in  the  program  of  Health  Education  the  rela- 
tionship of  vision  to  physical  well-being.  It  is  pretty  well  known 
that  even  the  minor  defects  of  the  eyes  may  lead  to  very  serious 
defects  with  reference  to  health.  It  seems  to  me  that  we  must  have 
our  school  buildings  so  lighted  that  there  shall  be  the  least  possible 
strain  to  the  eyes  of  the  children  who  are  going  through  the  schools. 
Of  pourse,  I  realize  that  may  not  be  the  work  of  the  individual 
teacher,  but  every  teacher  of  health  can  let  it  be  known  that  certain 
buildings  in  the  system  have  rooms  where  children  are  subjected  to 
eye-strain.  During  cloudy  days  all  book  work  should  be  suspended, 
or  if  we  have  artificial  illumination  it  should  be  sufficient  to  avoid 
eye-strain.  Teachers  should  be  trained  to  know  that  eye-strain  is 
more  important  than  literacy  in  regard  to  the  children  who  are  in 
the  school. 

"The  New  York  Committee  for  the  Prevention  of  Blindness 
located  in  New  York  City,  tries  to  assist  in  this  particular  program, 
and  has  literature  which  we  are  using  to  try  and  help  relieve  the 
situation." 

Following  Mr.  Carris,  Dr.  H.  E.  Kleinschmidt,  of  the 
American  Social  Hygiene  Association,  contributed  the  fol- 
lowing significant  suggestions.  He  said: 

"Dr.  Wood  asked  me  to  tell  you  something  about  social  hygiene.  Social 
It  seems  a  far  cry  from  social  hygiene  to  child  hygiene,  but  it  is  not.  Hygiene. 
The  prevalent  conception  is  that  we  are  only  engaged  in  the  combat 
against  venereal  disease.  Upon  studying  the  subject  it  was  found 
that  although  commercialized  prostitution  was  an  important  factor, 
other  factors  also  came  into  play  such  as  sex  education,  recreation, 
and  teachers  and  parents  qualified  to  teach  the  facts  of  sex.  The  more 
deeply  the  problem  was  analyzed,  the  more  many-sided  it  was  found 
to  be.  It  ramified  so  widely  that  today  social  hygiene  embraces  every- 
thing which  redounds  to  the  good  of  the  human  race,  and  while  the 
program  is  widespread  and  diffused,  we  are  probably  nearer  a  solution 
than  ever  before. 

"After  a  great  many  years  of  trying  this  and  that,  we  finally  recog- 
nized that  the  whole  situation  will  never  be  improved  until  there  is 
a  change  in  the  attitude  of  the  people,  about  sex.  It  is  perhaps  al- 
together a  matter  of  attitude  of  mind,  and  heretofore  the  attitude  has 
been  wrong.  We  cannot  do  much  with  the  adults.  The  hope  lies  in 
the  development  of  the  next  generation,  and  we  are  looking  far  ahead 
to  the  time  when  this  new  generation  shall  grow  up  and  come  to  the 
problem  with  an  entirely  different  set  of  ideas  regarding  the  processes 


34 


of  life  and  sex.     Then  I  think  we  will  accomplish  much  in  the  field 
of  social  hygiene. 

"If  this  is  to  be  accomplished,  as  I  have  suggested,  it  is  to  be 
accomplished  ,through  just  such  people  as  are  assembled  here.  It 
is  largely  a  problem  of  teaching,  of  education,  of  getting  the  correct 
ideas  over  early  in  life  and  anything  which  you  may  work  out  which 
will  redound  to  child  health  will  certainly  be  a  contribution  to  the 
so-called  social  hygiene  movement." 

The  discussion  on  this  paper  having  ceased,  Dr.  Wood 
introduced  Dr.  LeRoy  A.  Wilkes,  Medical  Director  of  the 
Board  of  Education  of  Trenton,  New  Jersey,  to  discuss 

Content  of  a  Health  Education  Program 


" 


Food  Facts 
Are  Sub- 
ject Matter 
Essentials. 


R.  DOOLEY,"  Peter  Finley  Dunn's  humorous  philos- 
opher,  in  discussing  Christian  Science,  once  said: 
"Hennissey!  The  Christian  Scientists  believe  there  is  no 
disease,  and  the  doctors  believe  there  is  nothing  else  —  and  I 
believe  that  if  the  doctors  had  a  little  more  Christianity  and 
the  Christians  had  a  little  more  Science,  you  might  get  well 
—  if  you  had  a  good  nurse." 

Sometimes  I  think  Dooley  has  shown  us  the  way  to 
follow  in  our  attempt  to  raise  the  physical  standard  of  the 
school  child. 

If  we  health  specialists  could  get  a  larger  and  more  har- 
monious view  of  the  real  physical  needs  of  the  child,  we 
might  supply  the  "little  more  Science"  to  the  pedagogue, 
who  in  this  case  is  the  "good  nurse,"  and  the  most  logical 
and  best  equipped  person  to  "get  it  over"  to  the  child. 
Health  Content:  What  are  the  really  basic  rules  of  health? 

It  is  often  painfully  evident  that  we  who  believe  so 
earnestly  in  education  in  health  and  health  in  education, 
are  not  all  agreed  upon  this  point.  I  often  ask  myself  and 
my  associates  in  Trenton  this  question,  and  we  have  at- 
tempted to  outline  the  rules  which  we  believe  can  be  best 
supported  upon  a  logical  or  psychological  basis. 

First:  We  (in  Trenton)  are  agreed  that  the  funda- 
mental facts  regarding  the  selection  and  preparation  of 
food  are  essential,  and  we  have  outlined  these  facts  briefly 
and  simply  as  follows: 

There  are  three  great  divisions  of  food  :  Body  Builders, 
Energy  Givers  and  Body  Regulators  ;  and  a  possible  fourth 
division,  known  as  growth  regulators,  i.  e.,  the  vitamines. 
Dr.  McCollum  will  give  us  the  necessary  details  about  these. 


35 

Some  portions  of  food  are  all  used  up  in  keeping  us 
well  and  strong.  Other  parts  of  the  food  build  tissue,  and 
still  other  parts  act  in  ways  that  help  the  body-builders  and 
energy-givers  by  furnishing  vitamines  and  mineral  salts, 
etc.,  and  regulating  the  body  functions.  Such  a  large  part 
of  the  body  is  water  (at  least  65  per  cent.)  we  must  daily 
take  in  at  least  a  quart  of  water.  The  water  content  may 
be  taken  in  various  forms  (i.  e.,  milk,  cocoa,  etc.).  Of 
course  milk  is  one  of  the  best  foods  because  it  has  prac- 
tically all  the  essential  parts  of  food  in  itself — body-builders, 
energy-givers,  body-regulators,  vitamines,  minerals  and 
water.  We  must  be  sure  that  it  is  clean  milk,  because  milk 
is  such  a  good  food  that  if  germs  get  in  it,  they  also  grow 
and  multiply  rapidly,  especially  in  the  cream.  Be  sure  that 
your  milk  comes  from  a  place  where  great  care  is  taken  in 
keeping  it  clean.  It  must  be  kept  upon  the  ice  so  that  it 
will  not  turn  sour.  This  is  a  bacterial  action,  and  low  tem- 
perature inhibits  bacterial  action.  Candy  and  food  eaten 
between  meals  tire  out  the  stomach  so  that  it  can't  work 
rightly  to  digest  your  meals.  Eating  between  meals  de- 
stroys the  appetite  at  your  meal  time.  Happiness  aids  di- 
gestion. Worry  hampers  it. 

It  seems  to  me  that  if  we  properly  select  and  prepare 
food  for  the  average  child,  we  need  be  concerned  only  in 
furnishing  at  least  the  necessary  minimum  caloric  content. 
The  maximum  need,  in  the  average  case,  can  be  determined 
by  the  child's  appetite.  In  my  experience,  over-eating  is 
not  particularly  dangerous  in  school  children,  when  the  food 
is  properly  selected  and  prepared.  (In  adults  the  danger 
of  over-eating  is  unquestionably  a  prominent  consideration 
in  health  maintenance.) 

The  "Don'ts"  or  things  to  be  avoided  in  connection  with  Four  Food 
the  subject  of  food  we  teach  are  as  follows : 

1.  Avoid  eating  between  meals.    One  can  except  milk, 

when  it  is  found  that  the  practice  does  not  destroy 
appetite  for  meals. 

2.  Avoid  soft,  doughy,  or  highly  spiced  food. 

3.  Avoid  fried  things  generally. 

4.  Avoid  tea,  coffee,  and  other  stimulants. 

In  connection  with  the  different  rules  of  health  we  have 
attempted  to  enlist  the  teachers'  interest  by  outlining 
briefly  the  pertinent  facts  in  relation  to  the  anatomy  and 


Don'ts. 


36 


Care  of 
Teeth  as  a 
Subject 
Matter 
Essential. 


Fatigue. 


physiology  involved,  in  an  attempt  to  make  clear  in  the 
teacher's  mind  the  reasons  in  support  of  measures  advo- 
cated. The  teacher  can  use  this  information  as  she  deems 
best,  when  the  pupil  questions  the  value  of  preventive  mea- 
sures outlined. 

The  teeth  are  not  to  be  regarded  as  ivory  "pegs"  stuck 
into  the  gums,  but  are  modified  body  tissue  like  the  hair, 
nails,  etc.,  and  depend  for  their  development  and  resistance 
against  disease,  upon  the  food  which  nourishes  all  parts  of 
the  body.  While  the  decay  in  teeth  always  begins  on  the 
outside,  the  external  influences  can  only  be  effective  in  pro- 
portion to  the  lowered  resistance  of  the  tooth  structure 
which  results  from  faulty  metabolism  from  several  causes, 
the  most  important  of  which  are  poor  diet  (especially  lack- 
ing in  minerals  and  vitamin es)  and  fatigue.  Some  claim 
that  faulty  glandular  secretion  is  involved,  but  the  main 
fact  to  remember  is  that  the  tooth  is  a  specialized  body 
tissue  and  is  nourished  and  protected  chiefly  by  bodily 
nutrition. 

If  for  no  other  reason  than  the  psychological  value — the 
appearance  and  feeling  one  experiences  from  regular  atten- 
tion to  oral  hygiene — we  should  regularly  clean  our  teeth 
with  a  proper  kind  of  tooth  brush  and  dentifrice  after  each 
meal  and  at  bed-time.  Decay  should  be  eliminated  at  the 
earliest  moment  it  is  discovered  in  order  to  save  the  teeth 
and  avoid  unnecessary  pain.  Much  emphasis  has  been  laic 
upon  clean  teeth,  but  healthy  teeth  are  so  intimately  asso 
ciated  with  diet  that  we  should  always  lay  the  emphasis 
here  and  on  the  fact  that  external  influences  can  only  be 
come  effective  when  the  bodily  resistance  is  lowered  in  th( 
ways  already  mentioned.  Every  child  should  consult  hi* 
own  dentist  at  least  every  six  months,  and  have  his  teetl 
kept  in  proper  condition. 

Second:  We  believe  that  the  subject  of  fatigue  rank} 
next  to  food  and  drink  in  importance.  In  discussing  th< 
relation  of  fatigue  to  malnutrition,  the  teacher  is  able  t< 
argue  convincingly  when  the  anatomy  and  physiology  hav< 
been  pointed  out  to  her,  viz. :  The  food  goes  into  one  end  o: 
the  digestive  tract,  which  is  a  tube  varying  in  size  an< 
structure.  It  is  about  30  feet  long,  and  its  largest  dilate< 
portion  is  called  the  stomach.  There  are  four  coats.  Three 
quarters  of  the  digestive  tract  is  muscle,  and  this  muscle  b; 
contraction  passes  along  the  food  (transportation)  so  tha 


37 

the  various  parts  of  the  functioning  portion  (innermost 
coat  or  intima)  can,  in  turn,  perform  its  particular  function 
in  selecting  from  the  semi-solid  food  mass  those  nourishing 
materials  which  give  us  strength  and  health.  Since  so 
much  of  the  digestive  tube  or  tract  is  composed  of  muscle 
we  can  readily  appreciate  why  we  cannot  get  the  best  re- 
sults from  even  the  best  kinds  of  food  if  we  are  "tired  out." 
One  should  rest,  if  very  tired,  before  eating. 

In  our  belief  there  are  two  stages  of  "being  tired,"  and 
the  distinction  is  of  importance.  The  first  stage  might  be 
described  as  that  of  "comfortably  tired,"  while  the  second 
stage  is  that  often  spoken  of  as  "too  tired  to  rest"  or  "going 
on  one's  nerves,"  and  borders  on  physical  exhaustion. 

Many  drugs  have  two  directly  opposed  actions,  i.  e.,  al- 
cohol first  stimulates  and  then  depresses.  In  somewhat 
similar  manner  do  we  tire — first  in  such  a  way  that  we 
find  great  relief  and  comfort  in  relaxation — but  the  ex- 
penditure of  energy  beyond  this  stage  causes  a  restlessness 
upon  relaxing,  during  which  sleep  is  impossible  and  no 
relief  is  available  until  we  pass  gradually  back  into  the 
"comfortably  tired"  stage  in  which  our  recuperative  powers 
can  work  to  the  greatest  advantage. 

By  the  term  "fatigue"  I  refer  to  the  second  stage  in 
which  we  are  calling  heavily  upon  our  reserve  strength. 
Fatigue  is  more  common  in  children  than  parents  and 
teacher  fully  appreciate.  AH  bodily  functions  are  retarded 
by  fatigue.  Many  undernourished  children,  while  in  this 
physical  state,  are  forced  to  eat  food  they  cannot  digest,  and 
to  practice  music  lessons,  run  errands,  etc.,  and  are  often 
punished  for  the  nervous  manifestations  which  accompany 
this  physical  state,  and  which  are  not  always  a  voluntary 
action. 

Much  stress  has  been  laid  upon  exercise,  but  in  my  ex- 
perience we  should  be  more  specific  in  our  teaching  about 
rest,  as  this  is  an  even  more  vital  subject  with  the  lower 
grade  children.  The  active  and  passive  types  of  rest  should 
be  explained.  The  thin,  nervous  "book-worm"  type  of  child, 
though  not  the  usual  type,  does  need  physical  exercise  to 
rest  his  weary  brain  and  restore  vitality  to  his  body.  This 
exercise  must  be  carefully  supervised  and  must  be  regularly 
taken.  Brain  workers  need  physical  diversion.  Physical 
workers,  and  most  children  come  under  this  classification, 
need  mental  diversion  and  physical  rest. 


38 


Elimina-  Third:  Regularity  of  Waste  Elimination.    Daily  bowel 

Waste  action  is  a  health  rule  we  cannot  neglect.  This  should  be 
made  a  daily  habit  from  birth,  and  strictly  observed 
throughout  our  lives.  The  bowels,  kidneys,  skin  and  lungs 
are  the  outlets  for  waste  disposal  in  the  bodily  economy, 
and  the  disposal  of  waste  cannot  anywhere  be  neglected. 
Mental  Fourth:  Cultivate  a  proper  mental  state.  Avoid  worry 

insofar  as  possible,  as  this  contributes  little  or  nothing  to 
the  solution  of  the  problems  causing  it,  and  has  a  direct 
unwholesome  effect  upon  the  nervous  and  digestive  systems, 
chiefly,  and  secondarily  upon  the  circulatory  and  respira- 
tory systems.  This  is  good  advice  for  parents  and  teachers 
as  well  as  pupils. 

Fifth:  Cleanliness.  "A  full  bath  in  warm  water  at  bed- 
time more  than  once  a  week"  cleans  the  skin,  opens  the 
pores  and  aids  in  the  elimination.  It  also  exercises  and 
tests  the  vaso-motor  mechanism  which  maintains  bodily 
temperature,  soothes  the  nerves  and  induces  sleep.  The 
psychological  effect  of  cleanliness  is  especially  good  as  it 
maintains  self-respect  and  morale,  which  are  intimately  re- 
lated to  health. 

Cool  or  cold  baths  are  stimulating  to  mind  and  body 
and  should  be  taken  daily  upon  arising.  One's  resistance  to 
disease,  especially  the  common  "cold,"  is  undoubtedly  raised, 
and  we  acquire  more  vitality  when  the  cold  shower  is  a 
daily  habit  upon  arising.  In  winter  of  course  the  room  must 
be  warm,  and  a  brisk  rub-down  must  follow. 

The  The  washing  of  the  hands  and  face  has  some  value  in 

hl^cal'  itself,  and  I  believe  it  has  a  tremendous  psychological  value 
Value  of  as  the  first  step  toward  improvement  in  general  cleanliness: 
and  should  therefore  be  encouraged  as  a  health  habit- 
especially  before  meals.  Adequate  facilities  are  not  pro 
vided  in  most  schools.  In  Framingham  (Mass.),  I  visitec 
a  new  building,  where  each  room  had  a  wash  bowl  in  it 
The  teacher  stood  at  the  door  upon  the  opening  of  schoo 
each  morning  and  inspected  the  children,  and  those  uncleai 
were  "permitted"  to  become  clean  before  association  as  ; 
member  of  the  class.  Infection  and  skin  diseases  are  mucl 
more  common  in  those  districts  where  cleanliness  is  les; 
marked,  and  in  my  school  health  supervision  experience 
have  seen  a  very  great  improvement  shown  in  the  contrc 
of  skin  diseases  and  infections  by  the  cleanliness  (at  leas 
of  face  and  hands  and  exposed  parts)  which  has  resulte 


39 

from  the  teachers*  efforts  upon  this  subject.  In  spite  of 
many  individual  extreme  costumes,  I  believe  that  the 
modern  clothes  are  a  distinct  improvement, — from  a  health 
standpoint. 

Correction  has,  until  recently,  been  overstressed,  almost 
to  the  exclusion  of  the  more  important  preventive  measures 
— and  I  do  not  wish  to  minimize  the  good  corrective  work 
that  has  been  and  is  still  being  done. 

The  oft-quoted  results  of  the  draft  examinations — i.  e., 
the  failure  of  33  per  cent,  of  the  flower  of  our  young  man- 
hood to  meet  ordinary  army  physical  standards — proved 
conclusively  that  something  must  be  done  to  offset  the 
undermining  influences  that  accompany  our  modern  life. 

The  old  walk  to  school,  often  of  a  mile  or  more,  is  re- 
placed  by  the  automobile  or  trolley  car,  which  carries  the  Advantages. 
child  to  the  door  of  the  school.  The  "movie"  robs  many 
children  of  sunlight  and  fresh  air,  and  often  of  time  neces- 
sary for  sleep;  overstimulates  the  nerves  and  emotions,  and 
in  the  "serial"  pictures  leaves  them  each  week  in  suspense 
as  to  the  ultimate  fate  of  the  heroine.  This  nervous  ten- 
sion disturbs  sleep  and  makes  for  the  unstable,  nervous 
systems  found  in  the  pale,  thin  children,  who  especially  are 
permitted  by  indulgent  parents  to  attend  too  frequently. 

As  a  natural  result  of  the  abuse  of  some  of  these  modern 
advantages,  and  from  many  other  causes,  we  have  fatigued, 
malnourished  children  who  are  problems  to  teacher  and 
parent.  To  these  are  added  many  other  children  whose 
physical  condition  could  be  decidedly  improved  in  the  early 
stages  of  deviation  from  normal  by  simple  procedures. 

In  cases  of  malnutrition  in  children,  though  "poundage" 
gain  is  perhaps  our  most  tangible  evidence  for  determining 
in  a  broad  sense  those  children  who  are  below  par  from  the 
standpoint  of  health,  we  must  always  consider  other  evi- 
dence, such  as  the  vitality  of  the  child.  This  real  vitality 
or  "pep"  must  be  carefully  distinguished  from  nervous 
energy  of  the  over-tired  restless  child.  The  latter  is  spas- 
modic in  type  and  the  child  lapses  back  into  a  peevish  state 
and  has  a  listless  expression. 

Some  children  require  prompt  medical  attention  before 
secondary  defects  appear,  or  the  original  defect  becomes 
incurable,  and  the  teacher  and  nurse  should  urge  the  parent 
to  provide  this  attention,  without  delay,  upon  notification 
from  the  school  principal  or  doctor. 


40 


Rating 
Teachers 
on  Health 
Returns. 


The  enormous  number  of  teachers  available  and  their 
wide  distribution  provides  an  unparalleled  opportunity  to 
give  to  children  the  "Rules  of  the  Game" — and  to  see  that 
they  play  accordingly,  which  is  the  really  important  part. 
Actual  physical  improvement  should  be  the  gauge  of  the 
teacher's  ability  in  the  program,  rather  than  the  knowledge 
gained  by  the  child.  The  "Rules"  are  not  complicated  and 
the  teacher  can  be  trained  to  determine  the  child's  general 
physical  condition  to  a  very  large  extent,  by  questions  and 
simple  measurements,  the  child's  habits,  state  of  health 
in  the  past,  his  growth-rate,  his  chest  expansion,  his  mental 
and  manual  ability,  his  regularity  of  attendance,  etc.,  and 
she  can  add  to  this  information,  where  it  is  available,  and 
it  should  be  everywhere,  the  report  of  the  doctor,  dentist 
and  others. 

Time  and  facilities  must  be  regularly  provided  in  the 
school  program  for  this  work,  and  the  teacher  should  be 
trained  in  Normal  School  in  these  simple  procedures.  This 
plan  will  enable  the  teacher  to  learn  something  of  the  child's 
general  "normal"  appearance,  and  she  will  thereby  be  bet- 
ter able  to  detect  the  first  signs  of  deviation  from  "normal" 
in  the  pupil.  Here  the  doctor  and  nurse  are  of  greatest 
value  to  both  teacher  and  pupil,  i.  e.,  in  "salvaging"  in  the 
early  stages,  those  children  who  are  beginning  to  deviate 
from  their  individual  "normal"  condition  as  determined 
previously  by  the  teacher  and  parent. 

When  a  child  shows  signs  of  deviation  from  the  mental 
average  for  his  age,  the  teacher  has  been  trained  to  consult 
his  parents  as  to  their  observations  and  opinion  regarding 
his  habits  and  actions  in  the  home.  Such  consultation  is 
even  more  urgent  when  there  is  a  question  of  possible  de- 
viation from  his  average  physical  condition,  though  this  has 
not  been  sufficiently  urged  upon  the  teacher  in  the  past. 

Ideally,  the  rating  of  the  teacher's  ability  should  be 
based  upon  the  physical  as  well  as  the  mental  improvement 
shown,  though  I  grant  that  this  is  something  hard  to  mea- 
sure definitely.  Increased  vitality  cannot  be  definitely  mea- 
sured as  yet.  If  the  teacher's  rating  is  based  solely  upon 
the  mental  improvement  shown,  as  is  the  customary  pro- 
cedure, that  is  where  her  effort  will  be  expended.  The  pos- 
sibilities of  the  teacher  in  the  program  of  health  are  not 
realized,  for  it  is  not  sufficiently  and  generally  appreciated 


41 

that    health    preservation    is    essentially    an    educational 
problem. 

Discussion 


The  discussion  of  Dr.  Wilkes'  paper  was  led  by  Miss 
Ethel  Beard,  Director  of  Health  Education,  Child  Health 
Demonstration,  Mansfield,  Ohio.  Miss  Beard  brought  to 
the  attention  of  the  Conference,  the  facts  that  we  must  pro- 
vide for  the  teachers  the  opportunity  to  live  the  life  of 
health  that  we  are  asking  them  to  teach;  and  that,  as  con- 
ditions now  are,  teachers  do  not  have  such  opportunity  in 
many  Teacher-Training  Institutions  in  this  country.  The 
latter  statement  she  based  upon  her  personal  acquaintance 
with  such  institutions  in  three  States.  She  concluded  by 
saying : 

"The  real  work  of  Health  Education  must  be  a  thing  of  spirit  Health 
coming  from  the  individual  teachers.  It  should  be  correlated  work  Education 
up  to  the  6th  grade.  It  means  also  a  wonderful  thing — it  means 
that  we  are  getting,  through  the  introduction  of  this  correlated 
health  work,  a  reduction  of  the  rigidity  of  our  American  school 
system  which  is  so  foreign  to  the  real  nature  of  childhood.  For  that 
reason  the  correlation  of  Health  Education  around  the  'Rules  of  The 
Health  Game,'  which  should  represent  the  fundamental  or  basic 
rules  of  health,  should  be  extended  so  that  all  of  the  teachers  are 
carrying  out  a  national  experiment.  The  teachers  and  children  are 
contributors." 

The  idea  advanced  by  Miss  Beard  was  endorsed  by  Miss 
Elma  Rood,  Teachers'  College,  Columbia  University,  who 
said: 

"We  must  give  the  teachers  more  knowledge  of  their  own  personal 
health  and  get  them  interested  in  living  it  themselves  before  we  can 
get  anything  across  in  the  schools.  The  situation  in  the  training 
schools  is  that  there  is  lack  of  physical  education  and  health  work. 
Conditions  in  which  the  teachers  have  to  live  in  the  rural  districts 
are  very  bad.  It  is  very  difficult  to  carry  out  rules  of  healthy  living 
in  isolated  sections,  with  no  conveniences.  When  they  come  into 
the  summer  sessions  of  the  Normal  Schools,  the  teachers  compare 
conditions.  I  think  we  should,  in  some  way  not  only  give  them 
inspiration  in  the  teacher-training  courses,  but  find  some  way  to 
improve  their  living  conditions  in  the  rural  districts." 

This  Miss  Rood  felt  to  be  a  teaching  opportunity  for 
nurses,  who,  through  the  children,  have  access  to  the  homes 
in  the  community,  and  can  thus  get  the  principles  of  health- 
ful living  across  to  mothers,  without  offending  them. 


42 


Aesthetic 

Health 

Chores. 


Mental 
Hygiene. 


Miss  Jean  here  added : 

"You  may  have  a  perfect  school  house  and  perfect  equipment 
and  it  is  of  no  value  unless  the  spirit  is  right — that  is  the  big  thing 
in  all  of  this.  Of  course  we  want  scientific  teachers  and  school 
buildings  properly  equipped,  but  they  are  of  no  value  unless  the 
teacher  has  the  spirit  and  thinks  that  health  is  of  fundamental  im- 
portance and  is  worth  a  great  deal  to  obtain." 

Mr.  Charles  M.  DeForest,  Director  of  the  Modern  Health 
Crusade,  then  said: 

"I  was  very  glad  that  Dr.  Wilkes,  in  speaking  of  the  ''Rules  of 
the  Game/  referred  to  cleanliness.  We  who  endeavor  to  serve  the 
anti-tuberculosis  movement,  made  it  a  'Rule  of  the  Game/  The 
washing  of  the  hands  and  cleaning  of  the  teeth  are  aesthetic  chores. 
I  was  talking  with  a  friend  the  other  day  who  spoke  about  the  dis- 
couraging influence  of  washing  your  hands  before  meals,  on  the 
grounds  that  you  could  not  make  your  hands  free  of  bacteria  unless 
you  gave  them  a  surgeon's  washing.  Washing  eliminates  75  per  cent, 
of  the  bacteria,  and  such  a  thing  as  massive  infection  might  be 
removed.  We  would  always  like  to  have  cleanliness,  and  we  consider 
washing  of  the  hands,  and  as  a  rider,  washing  of  the  face,  as  a 
psychological  influence. 

"In  one  of  the  lists  of  the  'Rules  of  the  Game'  that  I  have  seen 
there  is  also  nothing  about  mental  attitude.  In  our  side  of  the  anti- 
tuberculosis  work,  as  summarized  in  the  Modern  Health  Crusade, 
we  always  like  to  put  in  a  'Rule  of  the  Game/  which  we  call  a 
'chore/  about  the  mental  attitude:  'I  tried  to  be  cheerful  today.'  I 
believe  it  has  been  a  direct  influence  on  health,  and  it  seems  to  me 
that  it  might  well  be  stressed. 

"I  presume  we  cannot  settle  the  question  of  subject  matter  with 
any  rigidity.  It  must  be  revised  from  time  to  time." 

Mr.  Safford: 

"I  have  been  listening  here  for  someone  to  bring  up  the  important 
matter  of  mental  health.  It  is  a  well  authenticated  fact  that  between 
60,000  and  75,000  people  are  committed  annually  in  the  United  States, 
to  institutions  for  the  treatment  of  mental  diseases.  If  you  will  con- 
sider that  all  of  these  people  have  passed  through  our  public  schools 
and  that  many  who  are  to  become  like  them,  are  there  today,  you  will 
see  that  we  have  a  problem  which  is  of  first-rate  importance. 

"In  the  last  25  years  a  knowledge  of  the  origin  of  mental  diseases 
has  been  increased  through  the  new  psychology.  It  has  been  possible 
to  prevent  many  of  these  mental  diseases  and  to  cure  some  of  them. 
Great  progress  has  been  made  in  psychopathology  but  very  little, 
almost  nothing  corrective  or  preventive  has  been  done  in  the  schools. 
Many  cases  of  insanity,  neurasthenia,  and  nervous  prostration  have 
their  origin  in  early  childhood;  in  many  instances  before  the  child  is 
5  years  old  the  seed  is  planted. 

"This  subject  ought  to  have  some  place  in  a  program  of  health 
teaching.  Neurotic  conditions  of  teachers  and  pupils  ought  to  have 
some  consideration." 


43 


Miss  Julia  B.  Tappan  asked  Dr.  Wilkes  how  he  got  that 
information  which  the  doctors  have,  over  to  the  teachers 
in  Trenton. 

Dr.  Wilkes  replied: 

"First,  as  a  stepping  stone,  we  took  the  simple  'Rules  of  the 
Game,'  and  presented  them  to  the  teachers  and  said:  'Here  are  the 
fundamental  facts  that  we  would  like  to  get  over  to  the  child.  I  do 
not  know  much  about  the  elementary  grades.  My  job  is  to  give  you 
the  goods  and  your  job  is  to  deliver  them.  Come  back  and  tell  me 
how  you  do  it.'  The  most  original  of  the  teachers  took  these  simple 
rules  and  worked  out  marvelous  schemes  for  presenting  them  to  the 
child.  The  teacher  can  talk  directly  to  the  children.  She  is  the  most 
logical  person  and  the  best  trained  to  translate  that  material  into 
the  child's  language  so  that  he  can  understand  it.  The  content  is 
not  so  complicated.  It  is  a  question  of  distribution." 

The  reader  is  referred  to  the  section  on  "Successes  and 
Failures"  and  "Teacher-Training"  for  a  more  extensive  dis- 
cussion by  Dr.  Wilkes,  of  his  method  of  training  his 
teachers. 

Miss  Ethel  Perrin,  Assistant  Director,  Health  Educa- 
tion, Detroit  Public  Schools,  at  this  point  focussed  the  atten- 
tion of  the  Conference  once  more  upon  the  selection  and 
organization  of  subject  matter  by  proposing  the  Detroit 
plan.  She  said: 

"In   subject  matter   I  have   a   rather  new  division  here,   giving    The  Detroit 
six  fundamental  subjects,  and  from  these  six  fundamental  subjects 
to  lead  up  to  the  Rules  of  the  Game  or  the  Laws  of  Health : 

The  aim  is  to  give  the  child  increased  PHYSICAL  ABILITY, 
to  insure  NORMAL  GROWTH,  to  DECREASE  ILLNESS,  to 
AVOID  ACCIDENTS,  to  OVERCOME  DEFECTS  and  to  make 
possible  an  abundance  of  ENERGY  AND  VITALITY. 

To  achieve  these  results  it  is  necessary  to  bring  before  each 
child  through  experiences,  observation  and  reading  the  basic 
elements  of  health  and  to  instill  in  him  an  inner  urge  to  do  those 
things  necessary  to  a  healthful  life. 

I.  The  major  problems  about  which  this  health  program  will 

be  developed  are: 

1.  Normal  Growth  4.  Overcoming  Physical  Handicaps 

2.  Physical  Performance    5.  Safety  Education 

3.  Decreased  Illness  6.  Increased  Energy  and  Vitality 

II.  In  general  each  of  the  above  major  problems  will  be  devel- 
oped  from    the    standpoint   of   the   following    contributing 
factors : 


E'ducation 
Plan. 


1.  Food 

2.  Rest 

3.  Air 


4.  Exercise 

5.  Clothing 

6.  Cleanliness 


7.  Posture 

8.  Leisure  Time 

9.  State  of  Mind 


44 

III.     The  general  method  of  teaching  each  of  the  six  major  prob- 
lems should  be  as  follows: 

1.  Observe   physical   likenesses   and   differences   and   relate 
to  1,  Normal  Growth;  2,  Physical  Performance;  3,  De- 
creased Illness;   4,   Overcoming  Physical  Handicaps;   5, 
Safety  Education;  6,  Increased  Energy  and  Vitality. 

2.  Relate  the  contributing  factors  or  causes  of  health  (food, 
rest,  air,  etc.),  to  each  of  the  six  major  problems. 

3.  Interest  the  children  in  specific  problems. 

4.  Plan  individual  and  group  activities  for  the  solution  of 
these  problems. 

5.  The  teacher  may  find  it  worth  while  to  form  a  Health 
Club   (all  members  of  class)." 

Dr.  Wood  commented  on  the  fact  that  the  papers  so  far 
had  represented  two  different  phases:  The  Interest  and 
Understanding  of  the  Pupils ;  and  the  Interest  and  Under- 
standing of  the  Teachers. 

He  then  introduced  the  third  speaker  of  the  morning, 
Dr.  E.  V.  McCollum,  Professor  of  the  Department  of  Chemi- 
cal Hygiene,  Johns  Hopkins  University,  Baltimore,  Mary- 
land. Dr.  McCollum  brought  to  the  discussion  of  subject 
matter  a  summary  of  that  newer  knowledge  of  nutrition, 
an  understanding  of  which  all  the  workers  present  realized 
was  fundamental  to  their  task  of  Health  Education. 


Food  and  Health  Education 


Dr.  McCollum: 


WHAT  I  shall  say  to  you  will  sound  somewhat  different 
from  anything  you  have  already  heard  this  morning, 
since  my  own  experience  has  been  of  a  decidedly  different 
kind  from  that  of  the  other  members  of  this  Conference.  I 
have  had  relatively  little  experience  in  trying  to  teach  chil- 
dren, but  have  had  a  great  many  opportunities  to  discuss 
the  problem  with  people  who  have  had  such  experience.  It 
is  my  familiarity  with  the  science  of  nutrition  as  it  rests 
upon  animal  experimentation  and  upon  the  correlation  of 
knowledge  so  gained  with  human  experience  which  gives  me 
the  right  to  come  to  you  and  express  my  views. 

John  Burroughs  once  said  something  which  is  epigram- 
matic in  its  forcefulness  and  is  appropriate  on  this  occasion, 
i.  e.,  that  we  must  never  forget  that  we  are  built  up  around 
a  gut. 


45 

The  most  important  of  the  laws  of  health  relates  to  the 
character  and  quality  of  our  food.  Second  in  importance 
is  the  effectiveness  with  which  we  rest.  I  would  put  exer- 
cise third.  There  are,  of  course,  other  things,  such  as  clean- 
liness, temperature,  ventilation,  etc.,  which  are  of  impor- 
tance from  the  standpoint  of  physical  well-being,  but  they 
occupy  a  subordinate  position  in  a  program  for  physical 
betterment. 

Let  us  consider  for  a  moment  what  a  skillful  breeder  of  The 

,..,..,  ,,  hissential 

horses  does  for  a  very  fine  colt,  that  is,  the  progeny  of  simplicity 

extraordinary   parents — one   that   is   worth   one   hundred  of  a  Healthy 

,  -r-r.  ,  i      ,      /,          .         Regimen. 

times  as  much  as  the  average  horse.  His  method  of  caring 
for  it  is  a  very  simple  one.  His  first  consideration  is  to 
provide  for  it  the  right  kind  of  food ;  he  sees  to  it  that  the 
animal  has  food  which  experience  has  shown  will  be  ample 
for  the  support  of  optimal  growth  and  for  maintenance  of 
health  after  growth  is  completed.  Beyond  this  he  does  little 
in  any  special  way  to  look  after  its  well-being  other  than  to 
provide  for  it  shelter  and  an  opportunity  to  take  such  exer- 
cise as  it  desires.  There  is  no  more  enthusiastic  group  of 
people  from  the  point  of  view  of  wanting  exact  and  sound 
knowledge  concerning  food  values,  or  who  apply  the  prin- 
ciples of  nutrition  more  carefully,  than  that  group  inter- 
ested in  animal  production. 

We  are  very  fortunate  now  as  the  result  of  laboratory 
investigations  in  possessing  very  exact  knowledge  of  the 
dietary  properties  of  different  foods.  This  knowledge  is, 
however,  by  no  means  widespread,  although  much  has  been 
written  about  the  subject.  Few  have  studied  the  problem 
carefully  enough  to  become  well  educated  in  the  matter  of 
diet.  There  are  many  who  think  they  are  educated  in  this 
field — many  who  can  recite  glibly  the  list  of  foods  which  are 
said  to  constitute  a  satisfactory  diet,  who  can  enumerate 
the  known  vitamines  and  tell  about  the  different  deficiency 
diseases  which  come  from  a  lack  of  one  or  another  of  them. 
There  are,  however,  relatively  few,  if  my  experience  serves 
as  a  safe  basis  of  judgment,  who  can  satisfactorily  plan 
menus,  or  who  can  inspect  a  menu  and  tell  whether  it  is 
satisfactory  or  not,  except  in  most  general  terms,  and  if  not 
satisfactory,  tell  how  far  it  falls  short  and  in  what  factors 
lie  its  weaknesses.  I  think  it  is  safe  to  assert  that  a  great 
many  more  teachers  of  domestic  science,  and  a  considerable 
number  of  nurses,  are  much  better  able  to  do  this  than  any 


46 

other  group  more  or  less  interested  in  nutrition.  Certainly 
there  are  a  great  many  more  teachers  who  understand  the 
well  established  principles  of  nutrition  than  there  are  phy- 
sicians. I  have  come  in  contact  with  a  great  many  physi- 
cians, and  with  all  due  respect  to  them,  and  with  a  full 
appreciation  of  the  fact  that  there  are  many  remarkable 
men  in  the  medical  profession,  I  must  confess  that  rela- 
tively few  physicians  have  as  yet  taken  the  trouble  to  ac- 
quaint themselves  with  the  literature  in  this  field.  There 
seems  to  be  in  many  instances  a  feeling  of  self-importance 
which  goes  with  the  possession  of  a  degree  in  such  an  hon- 
orable profession  which  makes  it  very  hard  for  them  to 
accept  new  knowledge  from  non-medical  people.  The  result 
of  this  is  that  there  are  surprisingly  few  physicians  who  are 
competent  to  advise  on  the  subject  of  diet.  On  the  other 
hand,  I  have  found  a  certain  number  of  physicians  who  are 
quite  bold  in  giving  advice  whose  knowledge  of  the  results 
of  modern  research  in  this  field  is  almost  nothing.  We  must 
find  some  way  to  educate  the  next  generation  of  physicians 
in  matters  relating  to  nutrition,  for  in  only  this  way  can 
we  get  the  results  which  we  want.  I  must  emphasize  again 
that  what  I  have  said  does  not  apply  to  all  physicians ;  some 
of  the  ablest  practitioners  are  among  the  most  enthusiastic 
students  of  this  branch  of  science. 

Let  us  consider  again  for  a  moment  the  care  of  the 
valuable  colt.  After  it  is  fed  it  is  allowed  to  exercise.  It  is 
not  put  through  a  lot  of  contortions  or  made  to  lie  on  its 
back  and  kick  its  legs  to  get  exercise  of  a  suitable  nature ; 
it  walks,  trots,  or  runs,  and  with  these  simple  exercises,  and 
no  more  than  it  voluntarily  takes,  it  grows  into  a  magnifi- 
cent creature.  It  rests  a  great  deal  of  the  time.  It  is  not  an 
essential  thing  to  work  strenuously  in  order  to  develop  mus- 
cular power. 

Lions  as  Take  for  example  the  lion.    The  lion  and  its  family  live 

Health  on  a  rocky  knoll  on  the  margin  of  the  desert,  and  spend 
'rs'  their  day  there  in  a  state  of  rest.  They  come  out  at  night 
to  seek  their  food,  and  may  walk  or  trot  some  miles  in  seek- 
ing the  water  hole,  where  they  expect  to  find  food.  The 
only  vigorous  effort  which  is  made  is  in  the  last  rush  in  an 
effort  to  strike  down  their  prey.  As  soon  as  they  have  eaten 
they  return  home  and  there  sleep  as  late  as  a  grand  opera 
star,  yet  under  these  conditions — a  highly  satisfactory  food 
supply  and  no  special  effort  to  train  themselves  to  a  state 


47 

of  hardihood — they  remain  graceful  and  powerful  crea- 
tures, with  as  long  a  life  on  the  average,  barring  accidents, 
as  have  other  creatures  with  other  food  habits. 

Exercise  is  a  good  thing,  so  is  cleanliness.  I  would  not 
moderate  too  much  my  expression  of  admiration  of  these 
qualities,  for  I  thoroughly  recommend  them.  I  neverthe- 
less emphasize  this  point  here  because  there  is  a  group  of 
educators  who  seem  to  feel  that  exercise" is  the  most  im- 
portant means  of  building  up  strength  and  health.  I  want 
to  insist  that  we  cannot  make  exercise  take  the  place  of 
proper  nutrition. 

When  we  make  a  program  for  human  betterment  we 
must  understand  that  we  cannot  limit  our  instruction  and 
our  efforts  to  children  of  school  age.     We  must  consider 
all  children  of  all  ages.    From  the  standpoint  of  health  the 
most  important  time  in  the  life  of  an  individual  is  the  pre- 
natal period,  and  the  period  of  infancy  and  early  childhood. 
It  is  then  in  great  measure  that  the  size  of  the  fund  of  that 
something  which  we  call  vitality  is  determined.  It  is  then 
that  the  quality  of  the  teeth,  the  skeleton,  and  the  perf  ec-  when  to 
tion  of  form,  are  determined.     What  we  do  with  children  Begin  a 
of  school  age  is  to  be  looked  upon  as  a  salvaging  operation,  Health 
commendable  but  by  no  means  so  basic  in  its  significance  in  Program. 
the  life  of  the  individual  as  is  a  sound  health  program 
which  begins  with  the  expectant  mother,  and  ends  with  a 
properly  educated  young  adult. 

Women  who  are  expecting  to  have  children  are  enthus- 
iastic and  earnest  almost  without  exception  in  following 
any  advice  which  will  increase  the  prospects  for  the  health 
of  their  infants.  They  form  a  group  which  is  in  an  espe- 
cially receptive  mood,  and  their  cooperation  can  be  easily 
secured  in  applying  such  counsel  as  will  improve  their  own 
or  their  babies'  welfare.  Mothers  are  also  very  solicitous 
for  the  welfare  of  young  infants,  but  this  solicitude  grad- 
ually fades  as  the  child  grows  older,  and  is  much  less  pro- 
nounced when  it  reaches  school  age. 

School  children  can  be  made  an  effective  source  of  infor- 
mation to  parents,  and  it  is  through  the  education  of  school 
children  that  we  can  expect  to  improve  the  living  habits  in 
a  great  many  homes.  If  children  are  convinced  that  cer- 
tain living  habits  are  of  importance  and  promise  reward  of 
a  kind  in  which  they  are  interested  they  will  not  infre- 


48 


Health 
Teachers 
Must  Look 
the  Part. 


Teaching 
Nutrition 
Through 
Animal 
Experi- 
mentation. 


quently  be  insistent  or  even  tyrannical  in  their  demands  at 
home. 

It  is  a  matter  of  great  importance  in  the  teaching  of 
children  of  school  age  that  they  receive  their  instruction 
from  someone  who  will  serve  as  a  model  of  physical  fitness, 
beauty  and  health.  I  do  not  believe  children  in  general  are 
much  impressed  with  advice  about  nutrition  from  older 
people  who  themselves  do  not  present  evidences  of  physical 
success.  Children  are  impressed  with  such  physical 
prowess  as  the  athletic  feats  of  Douglas  Fairbanks,  and 
with  the  physical  perfection  seen  in  many  of  the  screen 
stars.  It  is  only  through  physical  beauty  and  physical 
power  that  the  interest  of  children  in  proper  living  habits 
is  to  be  secured.  Lessons  illustrating  the  contrast  between 
feeling  well  and  feeling  ill  do  not,  I  believe,  impress  the 
young  as  they  do  the  adult,  the  latter  having  a  better  ap- 
preciation of  a  sense  of  well-being  and  ill-being. 

It  is,  of  course,  impossible  to  secure  as  teachers  of  the 
young,  persons  who  exhibit  in  themselves  the  idea  of  physi- 
cal perfection.  This  is  the  ideal  but  it  is  scarcely  attainable 
at  present.  The  next  best  thing  is  to  illustrate  to  children 
the  importance  of  the  right  selection  of  food  by  means  of 
animal  experiments.  Such  contrasts  as  are  easily  obtain- 
able in  groups  of  laboratory  animals  fall  but  little  short  of 
being  as  striking  and  convincing  as  anything  in  human  ex- 
perience. We  need  to  have  more  people  trained  to  conduct 
for  educational  purposes  demonstrations  with  laboratory 
animals.  Pictures  go  a  long  way  toward  getting  the  results 
we  desire  but  they  do  not  take  the  place  of  the  living  animal. 
This  is  especially  true  where  different  groups  are  shown  to 
go  through  very  different  experiences  purely  as  the  result 
of  the  kind  of  food  provided  them,  some  failing  to  grow,  be- 
coming rough  and  timid,  while  others  grow  to  larger  size, 
and  become  strong  and  vigorous,  and  exhibit  gentleness  and 
freedom  from  anticipation  of  danger. 

It  is  of  great  importance  that  we  look  toward  a  better 
standard  of  perfection  than  we  are  now  doing.  I  do  not 
like  the  term  "normal"  as  it  is  now  used.  It  really  means 
nothing  more  than  a  fair  average  of  what  we  are  accus- 
tomed to  see.  When  one  contemplates  a  group  of  children 
who  are  passed  by  medical  inspectors  or  health  workers  as 
"normal"  one  must,  if  a  little  thought  is  given  to  the  mat- 
ter, conclude  that  our  standard  of  normality  really  applies 


49 

to  physical  inferiority  and  a  relatively  low  standard  of 
health.     It  would  be  much  better  if  we  adopted  the  term 
"optimal"  as  an  index  to  the  goal  toward  which  we  are 
working,  and  picture  in  our  mind's  eye  optimal  physical 
development,  beauty  and  health.     Every  child  should  be  "Optimal" 
taught  to  contrast  perfection  with  the  average  attainment  °*j™ 
in  our  population  in  order  that  he  may  have  an  incentive 
to  live  up  to  the  guiding  principles  which  will  best  promote 
his  development  and  protect  his  health. 

I  have  emphasized  repeatedly  in  recent  years  the  neces- 
sity of  taking  into  consideration  the  entire  life  history  of 
the  individual  rather  than  his  apparent  well-being  at  the 
time  of  examination,  as  the  basis  of  judgment  as  to  how  far 
we  are  attaining  or  failing  to  attain  our  objectives. 

We  need  scarcely  expect  rapid  and  effective  progress 
toward  the  ideal  in  physical  development  and  function  until 
we  have  put  into  operation  some  effective  procedure  for 
raising  the  standard  of  human  material.  Many  children 
now  come  from  parents  who  are  physically  inferior,  and  for 
this  reason  have  limited  possibilities.  I  do  not  see  any  hope 
at  present  for  applying  to  human  beings  any  of  the  well 
established  biological  principles  of  selection  and  weeding 
out  of  the  unfit  which  would,  if  applied,  do  more  than  any 
other  one  thing  which  we  could  do  to  improve  the  human 
race.  Endeavors  in  this  direction  are,  however,  not  recog- 
nized as  the  task  of  the  present  group  of  workers. 

We  have  just  passed  'through  a  period  covering  several 
years  in  which  the  teaching  of  health  rules  and  health 
chores,  etc.,  in  the  public  schools  has  been  over-advertised. 
Those  who  promoted  this  work  in  its  early  days  were  very 
optimistic  as  to  what  they  could  accomplish.  There  is  a 
tendency  now  to  reaction  on  the  part  of  the  public  and  to 
despondency  on  the  part  of  those  whose  enthusiasm  led 
them  to  promise  more  than  could  be  delivered. 

The  difficulty  as  I  see  it  lies  just  here — that  the  mistaken 
notion  gained  credence  that  one  can  start  with  a  child  of 
school  age  and  overcome  all  the  bad  effects  of  .earlier  mis- 
treatment or  misfortune.  We  have  fixed  too  largely  our 
attention  upon  the  school  child,  and  any  "effective  program 
for  human  betterment  must  include  plans  for  approaching 
in  the  right  way  the  solution  of  the  problems  of  persons  of 
all  ages.  These  mark  themselves  off  into  the  several  well 


50 

defined  periods  in  life — pre-natal  life,  infancy,  childhood, 
young  adult,  and  older  adult  life. 

The  most  effective  of  all  means  at  our  disposal  for  gain- 
ing the  desired  ends  is  through  the  teaching  of  nutrition 
and  of  rest.  Results  can  best  be  obtained  in  pre-natal  life 
through  the  education  of  dentists  and  public  health  nurses, 
and  at  present,  to  a  lesser  extent,  through  the  advice  of 
physicians.  This  situation  will  in  time,  I  hope,  be  reversed. 
At  present  I  see  the  greatest  hope  of  progress  through  the 
members  of  the  dental  profession.  They  are  a  very  teach- 
able group,  and  have  had  an  ideal  experience  during  the 
last  ten  years  to  fit  them  for  the  reception  of  new  ideas  as 
to  the  importance  of  proper  diet. 

During  the  last  year  I  have  had  an  exceptional  oppor- 
tunity in  meeting  very  large  numbers  of  dentists  at  their 
national  association  meetings  and  at  state  dental  society 
meetings.    I  find  all  the  wide-awake  dentists  in  the  country 
ready  to  acknowledge  that  they  have  had  sufficient  oppor- 
tunity to  observe  the  workings  of  the  slogan,  "A  clean 
tooth  never  decays."     They  are  convinced  that  it  is  not 
Revolu-        true.    Our  education  in  the  preservation  of  teeth  has  been 
tOv!fZldea8    *e~^  *n  £rea^  measure  to  those  financially  interested  in  the 
on  the  Care  sale  of  tooth  brushes,  paste,  and  washes,  and  we  have  been 
of  the  Teeth.  given  the  kind  of  education  that  might  have  been  expected 
from  such  teachers.     Nearly  all  the  good  teeth  which  our 
race  has  enjoyed  existed  before  the  tooth  brush  was  in- 
vented. 

I  have  asserted  repeatedly  in  recent  months  that  the 
most  fundamental  principle  in  preventive  dentistry  is  the 
development  of  a  sound  set  of  teeth.  The  teeth  are  enam- 
eled before  they  are  erupted,  and  the  development  of  the 
teeth  takes  place  in  pre-natal  life,  infancy,  and  early  child- 
hood. If  we  at  that  time  do  not  take  advantage  of  the 
opportunity  to  make  a  sound  set  of  teeth  they  will  there- 
after be  vulnerable.  The  shortsightedness  of  the  policy 
now  so  widely  advocated  of  solving  the  dental  problems  of 
the  race  by  multiplication  of  dental  clinics  for  the  repair 
of  children's  teeth  will  be  easily  apparent.  Such  a  program, 
while  commendable  from  the  standpoint  of  safeguarding 
the  health  of  persons  now  living  and  of  preventing  suffer- 
ing, is  to  be  commended  as  the  best  we  can  devise.  The 
same  program  offers  no  prospects  of  relief  from  a  situation 
which  has  become  all  but  intolerable.  Tooth  preservation 


51 

must  depend  upon  providing  within  the  teeth  their  own 
barriers  of  defense — protective  powers  which  reside  with- 
in the  living  tissues — such  as  the  body  has  in  respect  to  all 
its  parts. 

We  may  therefore  expect  the  dentists  to  very  quickly 
acquire,  as  I  know  they  are  doing,  the  fundamentals  of 
scientific  nutrition,  and  to  urge  this  upon  the  patients  to 
whom  they  have  an  opportunity  to  talk  while  operating 
upon  their  teeth.  I  am  very  enthusiastic  about  the  contri- 
bution to  human  welfare  which  this  profession  is  about  to 
make. 

During  the  last  three  years  we  have  conducted  in  our 
laboratory  many  hundreds  of  experiments  directed  toward 
demonstrating  the  effects  of  diets  faulty  in  one  or  more 
specific  ways  on  the  development  of  the  teeth  and  their 
preservation  after  eruption.  These  data  are  still  unpub- 
lished, but  I  may  state  here  that  nothing  in  my  experience 
has  been  more  convincing  than  these  data  in  showing  that 
the  diet  is  the  factor  of  supreme  importance  in  determining 
the  quality  of  the  teeth. 

I  must  also  express  my  great  appreciation  for  the  en- 
thusiasm of  health  nurses,  teachers,  and  many  physicians 
who  are  taking  up  this  line  of  endeavor.  My  desire  at  the 
present  moment  is  to  prevent  the  despondency  which  is 
apparent  in  some  individuals  through  failure  to  transform 
within  a  few  months  enfeebled  creatures  into  models  of 
physical  perfection.  I  hope  that  in  pointing  out  what  can 
be  done  for  a  human  being  in  different  epochs  in  its  life  I 
may  set  this  whole  subject  in  its  proper  perspective  and 
stimulate  interest  and  effort  toward  achievement.  I  have 
mentioned  briefly  the  subject  matter  or  perhaps  the  appeal 
material  which  will  be  most  useful  in  affecting  the  unborn 
child  and  the  infant,  also  the  child  of  school  age.  It  is 
little  less  important  that  a  campaign  of  education  be  pro- 
moted which  will  tend  to  correct  the  faulty  metabolism,  and 
•  elieve  the  attending  discomfort  and  brighten  the  outlook 
of  life  of  a  vast  number  of  adults  who  are  prematurely  A  Modern 
growing  old.  The  most  valuable  feature  of  this  line  of  Ofit%** 
endeavor  would  be  the  influence  on  young  adults  which  Fountain 
would  lead  them  to  make  an  earnest  effort  to  preserve  the 
characteristics  of  youth  while  they  have  them.  While  some- 
what beside  the  mark  in  the  present  restricted  discussion, 
I  may  say  that  the  same  appeal,  with  slight  modifications, 


52 


serves  here  as  serves  in  the  case  of  the  school  child,  i.  e., 
the  appeal  to  physical  beauty  and  the  figure  which  goes 
with  health.  There  are  few  now  who  realize  that  a  short 
and  effective  day  is  more  valuable  from  the  standpoint  of 
efficiency  than  the  usual  long  and  ineffective  day. 

If,  then,  we  adopt  a  comprehensive  plan  of  improving 
so  far  as  we  may  the  knowledge  and  personal  conduct  of 
individuals  of  all  ages  we  may  confidently  expect  not  only 
improvement  of  the  lives  of  individuals,  but  a  steady  growth 
of  the  spirit  of  appreciation  of  the  importance  of  applying 
scientific  knowledge  to  adult  life  for  the  special  purpose  of 
promoting  physiological  well-being.  As  time  goes  on  there 
will  be  an  accumulative  effect  which  will  become  manifest 
in  a  distinct  improvement  in  the  average  standard  of  well- 
being  in  human  beings. 


Super- 
vision of 
Nutrition 
Work  by 
Trained 
Specialists. 


Discussion 

The  discussion  of  this  paper  was  introduced  by  Miss 
Edna  White,  Director  of  the  Merrill-Palmer  School  of 
Detroit. 

Miss  White  said : 

"The  first  point  I  wish  to  emphasize  in  Dr.  McCollum's  discussion 
is  the  necessity  for  disseminating  accurate  information  regarding 
nutrition.  So  much  misinformation  has  been  given  out,  that  we 
are  now  facing  in  many  quarters,  a  reaction  against  nutrition  propa- 
ganda which  tends  to  discredit  the  whole  movement.  An  instance 
of  this  is  in  the  over-emphasis  that  has  been  given  weight  as  an 
indication  of  malnutrition.  The  weight  factor  has  been  a  useful 
device  to  interest  teachers  and  pupils  and  as  an  index  of  progress, 
but  there  has  not  been  sufficient  emphasis  on  the  fact  that  it  is  only 
one  factor  and  in  many  cases  not  the  most  important  in  diagnosis 
of  malnutrition.  In  consequence  there  has  been  a  reaction  and  in 
developing  our  health  work  in  Wayne  County  we  found  it  difficult 
to  secure  either  interest  or  endorsement  by  the  school  authorities 
until  it  was  made  clear  that  the  diagnosis  of  malnutrition  was  based 
on  many  other  factors  besides  weight.  The  recent  articles  in  the 
Outlook  while  in  many  respects  unfair,  have  received  considerable 
attention  and  credence  on  the  part  of  the  public  in  general.  All 
this  shows  the  necessity  of  supervision  of  educational  programs  and 
material  in  nutrition  by  trained  specialists,  and  the  desirability  of 
the  presentation  of  accurate  information  in  simple  terms. 

"We  must  recognize  that  the  organization  of  subject  matter  in 
this  field  depends  upon  the  group  to  whom  it  is  presented. 

"Nutrition  specialists  must  first  receive  basic  training  in  the  un- 
derlying sciences  and  develop  their  work  as  applied  science.  The 


53 


specialists  in  related  fields,  such  as  teachers,  nurses,  and  social 
workers,  who  are  often  the  agencies  directly  transmitting  information 
to  the  parents  and  children,  must  in  most  cases  rely  upon  empirical 
information  which  needs  to  be  carefully  chosen.  It  is  imperative  that 
they  recognize  their  limitations  and  the  necessity  of  trained  super- 
vision. The  trained  workers,  in  turn,  must  realize  that  the  specialists 
in  related  fields  have  often  not  the  same  science  basis  and  may  mis- 
interpret and  misapply  statements  they  do  not  understand. 

"The  trained  worker  should  be  available  so  that  problems  may 
be  constantly  referred  by  these  associate  groups.  In  Wayne  County 
we  have  worked  out  this  plan  by  having  a  county  supervisor  of  nutri- 
tion who  directs  the  work  and  gives  accredited  short  courses  to  the 
teachers  in  the  Elementary  Schools.  By  the  end  of  this  year  we 
will  also  have  given  similar  short  courses  to  every  group  of  public 
health  nurses  in  the  city  and  county  (approximating  in  number  275). 
Nutrition  bulletins  were  prepared  to  be  used  by  the  regular  teachers 
in  the  Elementary  Schools  in  connection  with  physiology  which  is  a 
required  subject.  A  casual  examination  of  any  primer  of  physiology 
will  show  how  inadequate  and  in  most  cases  absurd  is  the  information 
given  in  regard  to  food.  The  teachers  themselves  frequently  have  no 
idea  as  to  the  meaning  of  the  information  given,  since  it  is  phrased  in 
the  most  technical  terms  and  in  consequence  they  have  no  notion  of 
its  application  in  terms  of  everyday  living.  We  need  to  furnish 
sufficient  accurate  elementary  information  regarding  food  so  that  the 
child  may  be  able  to  make  an  intelligent  selection  of  his  own  food. 
We  have  been  satisfied  in  most  cases  with  doling  out  milk,  a 
remedial  measure  which,  if  unwisely  handled,  may  have  no  educa- 
tional value  whatever,  and  from  the  social  angle  may  be  a  questionable 
practice. 

"Lastly,  I  agree  most  heartily  with  Dr.  McCollum  in  feeling  that 
our  ideals  of  health  are  not  high  enough — we  are  too  often  satisfied 
with  being  able  to  get  about.  Our  teachers  must  believe  in  health 
and  'practice  what  they  preach'  so  that  our  children  are  taught  by 
example  as  well  as  precept." 

Miss  Adelaide  S.  Baylor,  Acting  Chief,  Home  Economics 
Service,  Federal  Board  for  Vocational  Exchange,  Wash- 
ington, D.  C.,  here  expressed  her  conviction  that  the  Con- 
ference should  "lead  to  more  perfect  team  work  of  the  spe- 
cialists in  nutrition,  physical  education,  physiology  and 
hygiene,  since  all  had  as  their  major  objectives  the  promo- 
tion of  health." 

Referring  back  to  the  subject  of  the  weighing  and  meas- 
uring of  children,  Dr.  Wilkes  said : 

"I  should  like  to  point  out  a  very  serious  error  that  has  been  made 
by  those  who  have  deprecated  the  school  use  of  weighing  children. 
Attention  has  been  fixed  on  a  very  small  portion  of  the  minority 
group  and  we  have  entirely  overlooked  the  great  mass  that  have  been 
improved  by  the  rather  concrete  methods  we  have  of  weighing  and 
measuring.  Handling  1,800  children,  18  per  cent,  of  the  children 


The  Inade- 
quacy of 
Most  Text- 
books on 
Nutrition. 


54 


Knowledge 
as  a  Pro- 
phylactic. 


(most  of  them  underweight),  are  improved  and  put  into  the  normal 
group — simply  because  we  have  nourished  them  and  endeavored  to 
point  out  the  defects. 

"Because  we  could  do  nothing  with  the  very  small  portion  of  the 
minority  group  these  people  are  ignoring  absolutely  the  most  con* 
vincing  kind  of  material  which  is  effective  with  large  groups,  because 
of  the  few  exceptions." 

Then  Miss  Jean  mentioned  that  Dr.  Wood  and  Dr.  Holt 
had  prepared  very  careful  articles  on  the  subject  of  weigh- 
ing and  measuring  of  children  in  answer  to  articles  which 
have  been  appearing  in  the  Outlook,  which  articles  have 
been  brought  out  in  the  form  of  a  pamphlet  by  the  Child 
Health  Organization. 

Dr.  Wood  here  contributed  an  interesting  reaction  to 
Dr.  McCollum's  paper,  saying: 

"I  am  going  to  recite  a  little  lesson  based  partly  upon  Dr.  Mc- 
Collum's recent  work.  I  said  it  before  him  and  he  seemed  pretty 
well  to  agree  with  it.  Let  me  give  it  to  you  briefly.  It  is  my 
interpretation  of  the  best  material  I  can  find.  For  example,  all 
commercial  vitamines  are  quite  worthless  so  far  as  our  scientific  in- 
vestigations show  us,  though  I  understand  there  is  no  agreement. 
A  recent  article  reported  tests  upon  rats  with  vitamine  preparations, 
and  the  test  favored  one  preparation,  but  showed  no  evidence  essen- 
tially in  favor  of  the  others.  Dr.  McCollum's  latest  article,  which 
appeared  this  week  in  the  Journal  of  the  American  Medical  Associa- 
tion, reports  that  his  recent  experiments  give  no  proof  of  the  value 
of  any  of  them.  The  people  of  the  country  are  spending  millions 
for  these  elixirs  of  life  and  health  and  youth,  and  one  of  our  obliga- 
tions is  to  try  to  interpret  the  nutrition  phase  of  knowledge  in  the 
matters  of  health,  not  only  to  children,  but  to  adults.  In  the  next 
place,  I  gather  that  our  ordinary  diet  has  too  much  of  white  bread, 
potatoes,  animal  muscle,  and  sugar — that  the  things  that  should 
be  emphasized  particularly  in  the  diet  are  two  salads  a  day — salads 
twice  a  day — because  of  the  very  valuable  material  that  salads  contain, 
represented  by  raw  lettuce,  celery,  cabbage,  and  other  leafy  materials ; 
that  we  have  what  Dr.  McCollum  calls  the  'pot  herb'  represented 
by  spinach  and  leafy  vegetables;  and  that  we  should  have,  somewhat 
independent  of  age,  a  quart  of  milk  a  day  or  its  equivalent  in 
manufactured  dairy  products.  That  may  be  changed  next  year  or 
next  month,  but  I  give  it  as  an  illustration  of  the  best  practical 
synthesis  that  I  can  find  at  present." 

Both  Mrs.  Henrietta  Calvin,  Specialist  in  Home  Eco- 
nomics, Bureau  of  Education,  Washington,  D.  C.,  and  Miss 
Laura  A.  Cauble,  Bureau  of  Nutrition,  Dairymen's  League 
Cooperative  Association,  Inc.,  New  York  City,  brought  out 
the  great  teaching  value  of  concrete  demonstrations  of 
nutritional  effects  produced  by  feeding  and  other  environ- 


55 

mental  factors,  on  plants  and  animals,  when  such  demon- 
strations can  be  scientifically  conducted  and  carefully  con- 
trolled by  responsible  people.  The  value  of  well-chosen 
exhibits  illustrating  food  values  was  noted  by  both 
speakers. 

Miss  Jessie  Hoover,  Milk  Utilization  Specialist,  Bureau 
of  Animal  Industry,  United  States  Department  of  Agricul- 
ture, Washington,  D.  C.,  in  commenting  on  the  carrying 
power  of  the  concrete  methods  of  the  nutrition  class,  told 
the  following  story,  which  shows  in  an  amusing  way  how 
one  child  tried  to  use  her  knowledge  to  the  advantage  of 
her  pets.  Miss  Hoover's  story  goes  as  follows: 

This  story  is  about  the  little  daughter  of  my  chief  and  it  goes 
to  prove  that  children  get  ideals  and  carry  them  over  into  their  lives. 
Her  father  came  home  from  the  office  one  evening  and  found  that 
she  had  a  little  playmate  with  her,  and  they  had  gathered  seven 
of  the  neighborhood  cats  into  the  dining  room.  On  the  dining-room 
table  were  seven  sheets  of  paper  and  at  the  top  of  each  sheet  was 
written,  "Nutrition  Record  of  Teddy,  Dick— Tom — etc."  Under  Ted- 
dy's record  was  written,  "Nine  pounds  with  normal  fur";  then 
"Diet — Thirteen  saucers  of  milk  and  three  eggs."  This  record  varied 
in  the  case  of  each  cat.  The  little  girl  went  to  bed  at  the  usual 
time  that  evening.  While  undressing  she  called  down  to  her  father 
below,  "How  do  you  spell  nutrition?"  The  father  told  her,  and  then 
she  asked,  "How  do  you  spell  clinic?"  He  also  told  her  that.  Later 
on  in  the  evening  her  father  went  upstairs,  after  she  was  asleep,  to 
see  what  she  had  been  doing,  and  he  found  that  each  sheet  of  paper 
had  been  headed  "Nutrition  Clinic." 

Dr.  Richard  A.  Bolt,  General  Director,  American  Child 
Hygiene  Association,  concluded  the  discussion  by  stating 
that  he  believed  Dr.  McCollum  had  struck  a  keynote  when 
he  said  that  the  principles  of  nutrition  were  the  funda- 
mental health  habits  around  which  others  must  be  built,  and 
that  it  is  important  to  distinguish  between  health  habits 
and  habits  which  are  aesthetic. 


Section  HI 

THE  PLACE  OF  HEALTH  EDUCATION  IN 
THE  CURRICULUM 

THE  Conference  next  addressed  itself  to  the  problem 
of  the  wisest  possible  distribution  of  the  subject  matter 
just  recommended.    In  comment,  the  Chairman  struck 
this  important  note : 

"We  must  realize  that  it  is  of  great  importance  to  put  into  the 
field  of  subject  matter,  material  that  is  as  up-to-date,  as  scientific, 
as  well  authenticated  as  possible.  We  must  try  to  depend  upon 
the  most  authoritative  sources,  the  best  authorities  for  this  material. 
We  cannot  always  be  sure  of  the  accuracy  and  the  balance  of 
emphasis  in  material  values,  I  suppose,  even  in  the  official  reports 
from  Boards  of  Health,  or  from  any  human  source,  but  some  sources 
are  more  dependable  than  others.  I  will  give  you  one  very  simple 
illustration.  Supposing  we  took  this  range  of  material  that  we  get 
from  the  voluntary  organizations.  When  a  Life  Insurance  Company 
puts  out  material  in  the  health  field,  if  we  are  reasonably  familiar 
with  it,  we  may  appreciate  the  fact  that  the  modern  Life  Insurance 
Company  is  not  only  selling  insurance,  but  also  health.  It  will  be 
likely,  therefore,  to  get  the  most  authoritative  material  in  the 
health  field.  (I  have  no  desire  to  advertise  life  insurance  companies.) 
When  we  have  health  devices  from  the  commercial  manufacturers  of 
materials,  we  should  be  very  careful.  They  are  apt  to  be  biased — 
prejudiced — in  favor  of  their  particular  manufactured  products.  In 
other  words,  they  are  not  primarily  selling  health.  Commercial  people 
are  selling  specific,  specialized  products.  Perhaps  that  simple  prin- 
ciple is  thoroughly  enough  illustrated  and  emphasized  in  just  this 
way. 

"The  topic  of  this  session  is  'The  Place  of  Health  Education  in 
the  Curriculum/  The  first  paper  is  by  Dr.  Maurice  A.  Bigelow, 
Professor  of  Biology,  and  Director,  School  of  Practical  Arts,  Teach- 
ers' College,  Columbia  University,  New  York  City." 

The  Place  of  Health  Education  in  the  Programs 
of  Schools  and  Colleges 

Dr.  Bigelow: 

LET  me  begin  by  stating  my  confession  of  faith  in  Health 
Education. 

I  believe  in  Health  Education  not  as  any  cut-and-dried 
or  special  form  of  program  which  has  come  to  my  knowl- 
edge, but  simply  as  a  broad,  general  movement  for  center- 

(56) 


57 

ing  the  attention  upon  the  importance  of  giving  more  con- 
sideration to  the  problems  of  health.  Some  18  or  19  years 
ago  I  renounced  my  belief  in  the  old,  formal  physiology  so 
far  as  the  first  six  years  of  school  life  were  concerned. 
Beyond  that  time  I  have  a  little  different  point  of  view. 
I  state  this  confession  of  general  faith  in  Health  Education 
because  I  am  going  to  say  some  things  that  may  sound 
critical.  Please  understand  that  I  am  in  general  sympathy 
with  most  of  the  ideas  of  the  movement.  In  criticizing 
some  details  I  am  trying  to  save  the  movement  from  some 
over-zealous  friends,  as  well  as  from  some  of  its  mis- 
understanding enemies.  I  say  this  so  as  to  explain  some 
things  which  may  sound  somewhat  critical. 

/ — The  Relation  of  Health  Education  To  Its  Predecessors, 
"Physiology"  and  "Hygiene" 

In  planning  for  a  nation-wide  health  educational  move- 
ment we  may  save  ourselves  the  task  of  uselessly  repeating 
much  of  a  long  chapter  of  the  history  of  science  education 
if  we  remember  that  we  are  not  dealing  with  a  recently 
discovered  phase  of  education,  as  some  enthusiasts  seem  to 
believe.  "Health  Education"  is  a  very  new  name,  but 
trying  to  teach  how  to  maintain  natural  health  under  the 
more  or  less  unnatural  conditions  imposed  upon  us  by 
modern  civilization  is  no  new  thing  in  American  education. 
Certain  school  books  on  health  had  a  large  circulation  be- 
fore 1840,  and  in  1842  Horace  Mann  devoted  about  one 
hundred  pages  of  his  sixth  annual  report  as  Secretary  of 
the  Board  of  Education  of  Massachusetts  to  a  statement 
and  defense  of  health  study  as  a  school  subject  which  has 
not  been  equaled  by  any  later  writer.  Numerous  other 
prominent  writers  on  science  education,  notably  Herbert 
Spencer  in  "Education"  (1861)  and  Huxley's  "Essays" 
(1876  and  1877),  have  emphatically  advocated  scientific 
study  of  human  health  in  schools  and  colleges. 

It  is  true  that  many  of  these  educators  wrote  under  New 
such  titles  as  "the  study  of  physiology  and  hygiene,"  but, 
nevertheless,  an  extensive  historical  inquiry  into  the  Ameri- 
can teaching  concerning  health  during  the  nineteenth  cen- 
tury has  convinced  me  that  our  new  "Health  Education" 
is  in  very  great  measure  a  new  label  for  a  greatly  improved 
brand  of  goods  which  under  any  of  the  old  names  could 


58 

not  be  marketed  in  the  educational  field  as  extensively  as 
their  importance  demands. 

Please  understand  me,  then,  as  not  laboring  under  the 
popular  delusion  that  Health  Education  is  a  brand  new 
subject  to  be  forced  into  the  curricula  of  schools  and  col- 
leges. Fundamentally,  Health  Education  contains  compara- 
tively little  new  and  important  knowledge  which  would  not 
be  found  in  the  old  physiology  and  hygiene. 

What,  then,  are  the  distinguishing  characteristics  of 
this  new  movement?  So  far  as  the  chief  aims  and  subject 
matter  is  concerned,  Health  Education  as  a  phase  of  prac- 
tical science  education  is  a  very  new  name  for  the  very  old 
idea  that  study  of  the  human  body  in  relation  to  its  environ- 
ment will  somehow  give  the  individual  human  a  key  to 
greater  health,  and  hence  greater  efficiency  and  happiness, 
making  life  more  worth  the  living.  But  Health  Education 
of  today  implies  more  than  scientific  subject  matter.  It 
also  means  up-to-date  educational  methods;  it  means,  in 
general,  more  educational  emphasis  on  the  applications  of 
science  to  successful  human  living  ;  it  means  a  broader  field 
than  was  commonly  included  in  the  old  physiology  and 
hygiene  of  the  public  schools  and  most  colleges;  it  means, 
as  I  shall  point  out  in  the  next  section,  teaching  for  health 
that  is  much  more  than  physical.  In  all  these  respects 
Health  Education  can  be  made  so  different  and  so  much 
more  efficient  than  the  old  studies  which  had  the  same 
general  aims  and  subject  matter  that  for  the  sake  of 
clearing  away  all  the  old  mistakes  and  hopeless  misunder- 
standings, both  of  teachers  and  of  the  intelligent  public, 
it  is  good  that  educational  leaders  have  decided  to  drop 
the  old  terminology  and  to  place  an  absolutely  new  label 
on  a  new  way  of  working  for  the  old  idea  of  more  health 
through  education.  So  much  for  the  relation  of  the  Health 
Education  of  today  to  its  predecessors  in  our  educational 
system. 

//  —  The  Larger  View  of  Health  in  Education  —  Health  as 
Both  Personal  and  Social  Welfare 

It  is  important  that  Health  Education  as  a  whole,  ex- 
Viewof96r  tending  from  Kindergarten  through  Junior  College  years, 


e  organized  on  a  broad  basis,  including  health  as 
both  personal  and  social  welfare,  and  meaning  much  more 


59 

than  health  as  that  term  is  usually  applied  to  the  physical 
well-being  of  the  human  body.  It  will  seriously  hamper 
the  movement  if  there  is  broadcasted  the  impression  that 
Health  Education  is  simply  improved  hygiene  in  the  old 
physical  sense. dSba.  .truth  is-that  our  conception  of  the 
field  of  hygiene  has  expanded  rapidly  during  the  two  dec- 
ades of  this  twentieth  century.CLHygiene  once  meant,  and 
still  means  to  most  people,  mere  physical  health,  i.  e.,  the 
proper  working  of  the  machinery  of  physical  or  animal 
existence.  But  this  is  too  limited  and  narrow  for  our  highly 
organized  civilization  in  which  the  healthy,  joyous,  efficient 
individual  life  must  perforce  have  in  it  many  elements 
which  are  vastly  more  than  physical  living,  because  the 
psychical  and  social  aspects  of  life  have  become  so  highly 
developed.  The  study  of  healthful  living  must  be  more  than 
personal  and  public  hygiene  concerned  with  physical  and 
bodily  health,  it  must  also  deal  with  healthy  mental  life; 
and,  to  be  complete,  it  must  touch  social  health  or  social 
welfare  of  society,  which  scientifically  means  groups  of 
two  or  more  human  beings. 

In  short,  hygiene  as  the  science  of  healthful  living  was 
fifty  years  ago  entirely  physiological,  in  the  eighties  and 
nineties  of  the  last  century  it  absorbed  the  pertinent  bac-  Sociological 
teriological  discoveries,  still  later  the  psychological  claimed  f^H^k- 
a  place,  and  in  the  last  twenty  years  we  have  begun  to  ful  Living. 
recognize  the  importance  of  many  sociological  elements  in 
the  problem  of  the  healthful  and  successful  living  together 
of  men,  women  and  children  on  this  planet  of  ours. 

Of  course,  the  inclusion  of  the  sociological  problems  of 
family  and  community  health  or  welfare  expands  hygiene 
to  the  European  scope  of  social  hygiene  as  represented  by 
the  present  activities  of  the  social  hygiene  organization  of 
France  and  also  by  Havelock  Ellis  in  his  well-known  "Task 
of  Social  Hygiene."  These  cover  a  multitude  of  problems 
concerning  social  health  or  welfare.  Many  of  the  problems 
are  already  well  placed  under  sanitation  and  sociology,  and 
the  result  is  that  in  Europe  the  prominent  problems  of  what 
they  call  social  hygiene  in  its  largest  sense  of  social  welfare 
are  those  which  in  America  we  have  agreed  to  locate  in 
social  hygiene  in  its  narrow  sense,  namely,  the  problems  of 
social  health  or  welfare  which  have  grown  out  of,  or  are 
closely  related  to  the  fundamental  sexual  instinct.  For 
example,  some  of  the  chief  topics  considered  under  social 


60 

hygiene  abroad  are:  the  feminist  movement,  state  regula- 
tion of  marriage  and  divorce,  eugenics,  the  problem  of 
venereal  diseases,  legal-social  control  of  sexual  conduct, 
the  reproduction-control — understood  here  in  America  as 
part  of  our  limited  social  hygiene  movement  because  they 
are  clearly  problems  centered  around  the  phenomena  of 
sex. 

It  is  perhaps  unfortunate,  both  for  the  limited  field 
called  social  hygiene  and  for  the  broader  field  of  social 
health  or  welfare,  that  in  the  American  usage  social  hygiene 
has  replaced  and  broadened  sex  hygiene.  However,  so  far 
as  the  needs  of  American  education  are  concerned,  we  can 
use  satisfactorily  the  phrase  "social  welfare"  to  include 
as  much  as  the  European  social  hygiene.  In  fact,  it  is 
significant  in  this  connection  that  the  leaders  of  the  educa- 
tional phase  of  our  American  social  hygiene  agree  that 
the  subject  should  not  appear  as  such  in  our  educational 
program,  but  should  be  merged  and  even  submerged  in 
a  larger  program  for  the  teaching  of  human  welfare 
through  various  subjects  which  naturally  have  bearings 
on  health  in  its  widest  sense.  Hence  the  American  usage 
of  social  hygiene  as  designating  the  group  of  the  chief 
problems  of  the  larger  social  hygiene  of  Europe  does  not 
concern  our  broadening  our  conception  of  Health  Education 
to  include  those  aspects  of  social  health  which  are,  after 
all,  of  personal  meaning  because  they  react  so  definitely 
upon  the  individual.  For  illustration,  take  such  a  simple 
case  as  teaching  young  people  to  control  their  tempers  so 
that  the  word  "indignant"  is  strong  enough  to  describe 
correctly  their  reactions  to  other  people.  Here,  selected 
from  numerous  common  situations,  is  a  clear-cut  problem 
of  social  welfare  or  social  health  which  seriously  concerns 
society;  that  is,  the  relations  of  two  or  more  individuals. 
At  the  same  time,  it  is  a  problem  of  personal  health  because 
a  temper  running  amuck  is  not  good  for  the  individual's 
nervous  system,  as  proved  by  the  rebound  on  digestive, 
circulatory,  and  other  organs.  Another  illustration  may 
be  drawn  from  the  most  complicated  of  human  social  rela- 
tionships, namely,  the  mental  and  social  adjustments  in 
family  life.  Disharmony  or  maladjustments  of  men,  women 
and  children  in  homes  is  bad  social  health  which  reaches 
the  extreme  of  social  ill-health  when  a  family  disintegrates. 
At  the  same  time,  every  family  physician  knows  what  a 


61 


lot  of  personal  ill-health  is  the  result  of  the  social  malad- 
justments of  the  family  reacting  on  the  physiological  proc- 
esses of  the  persons  concerned. 

Do  I  make  clear  my  point  that  Health  Education  must 
set  its  horizon  far  beyond  that  of  the  old  physical  hygiene? 
That  is  no  longer  satisfactory  because  it  is  bounded  by  the 
directly  physiological,  or  indirectly  bacteriological,  aspects 
of  individual  health  in  the  sense  of  freedom  from  the  dis- 
orders which  demanded  medical  aid.  Under  the  heading 
of  "Health  Education"  we  must  be  free  to  include  any  prob- 
lems of  personal,  family,  and  community  or  social  health 
or  welfare  which  in  both  direct  and  remote  ways  react  on 
the  physical  and  mental  and  social  well-being  of  the  indi- 
viduals who  are  the  fundamental  units  of  society. 

So  much  in  favor  of  the  larger  outlook  of  Health  Edu- 
cation. 

/// — Health  Education  in  Kindergarten  and 
Elementary  Schools 

may  be  taught : 

(a)  as  a  special  subject  prescribed  by  law, 

(b)  in  nature-study  or  "science," 

(c)  in  physical  education, 

(d)  in  language  work, 

(e)  in    home-making    and    home-living    classes,    for    both 
boys  and  girls, 

(f)  incidentally   in   "social    science"    and   moral    education 
topics,  and  in  extra-curricular  activities  as  supervised 
playgrounds. 


Health 
Education 
in  Ele- 
mentary 
Schools. 


Avoid  over-emphasis  on  the  word  "health"  or  its  oppo- 
sites  "disease"  and  "illness."  Ultimately,  and  in  private 
schools,  most  important  topics  in  a,  b,  c,  f  should  be  merged 
under  the  general  heading  "practical  science,"  extending 
from  Kindergarten  through  Junior  High  School  years. 

The  big  problem  is  training  teachers  already  in  service 
in  the  Elementary  Schools.  We  need  special  "practical 
science"  teachers  in  graded  schools  just  as  much  as  music 
and  fine  arts  teachers.  For  small  schools  we  need  better 
teachers'  guides  to  textbooks.  We  need  textbooks  which 
must  be  more  than  "readers." 


62 


Health 
Education 
in  High 
Schools. 


Health 
Education 
in  Colleges 
and 

Teacher- 
Training 
Institu- 
tions. 


IV — Health  Education  in  High  Schools 

may  be  taught : 

(a)  in  Junior  High  School  and  year  I  of  four-year  schools 
(prescribed  by  law), 

(b)  in  "general  science" 

(c)  in  biological  science, 

(d)  in  hygiene,  personal  and  community, 

(e)  in  physical  education, 

(f)  in  home-making,  and  home  living, 

(g)  in  literature, 

(h)   in  social  science  and  psychology, 

(i)   in  extra-curricular  activities, 

(j)   in  lecture  series  on  home  health  and  home  living. 

V — Health  Education  in  Regular  Liberal  Culture  Colleges 

may  be  taught: 

(a)  in  hygiene — general,  personal  and  community, 

(b)  in    biology     (especially,    its    physiology    and    applied 
-  chemistry), 

(c)  in  physical  education, 

(d)  in  home-making, 

(e)  in  sociology, 

(f)  in   psychology, 

(g)  in  ethics, 
(h)  in  literature. 

Most  of  the  best  health  teaching  in  American  colleges 
is  now  done  by  teachers  of  biological  sciences  or  of  hygiene. 
The  college  physician  as  such  is  rapidly  losing  his  old-time 
hold  on  the  hygiene  courses.  Very  little  in  the  professional 
medical  training  and  experience  of  a  physician  fits  him 
directly  as  a  lecturer  in  Health  Education.  Much  tends  to 
unfit  him.  Therefore,  the  college  physician  should  function 
as  a  lecturer  on  health  only  when  his  medical  training  has 
been  supplemented  by  educational  study,  and  especially  by 
study  of  the  hygiene  of  normal  life,  so  that  he  deserves  a 
dual  appointment  as  college  physician  and  professor  of 
Health  Education.  Already  there  are  a  score  or  more  of 
such  men  and  women  in  this  country.  They  are  not  likely 
to  increase  in  the  larger  colleges  for  the  reason  that  in 
those  institutions  the  duties  of  the  college  physician  com- 
bine both  those  of  medicine  and  health  officer,  and  allow 
no  time  for  more  than  occasional  lectures  on  health  im- 
provement or  conservation. 

These  remarks  regarding  college  physicians  apply  also 
to  school  or  college  nurses.  Professional  training  for  nurs- 


63 

ing  does  in  itself  not  prepare  for  teaching  hygiene.    Sup- 
plementary training  is  necessary. 

VI — Health  Education  in  Graduate  Teacher -Training 

Colleges 

In  these  the  opportunity  is  similar  to  that  in  regular 
Normal  Colleges,  but  in  addition  to  good  technical  prepara- 
tion, instructors  who  are  to  train  students  in  Normal  Schools 
to  be  teachers  of  Health  Education  should  have  a  thorough 
knowledge  of  educational  psychology,  history  and  philoso- 
phy of  education,  and  fundamental  principles  of  teaching. 

Discussion 


Dr.  Wood  then  asked  Dr.  Caroline  Croasdale,  Professor 
of  Hygiene,  and  College  Physician,  New  York  State  College 
for  Teachers,  to  open  the  discussion. 

Dr.  Croasdale: 

"In  this  brief  discussion  I  shall  limit  my  remarks  to  'Health  Edu- 
cation in  Teacher-Training  Colleges.' 

"Before  attempting  to  discuss  the  place  cf  Health  Education  in 
the  curriculum  in  such  institutions  it  seems  logical  to  enumerate  some 
of  the  aims  or  functions  to  be  served  by  such  a  course — many  are  so 
obvious  of  course  as  to  need  no  mentioning.  The  following  three 
are  perhaps  enough  out  of  the  beaten  path  of  thought  along  this 
line  to  be  worth  considering  for  a  moment, — first: 

"Let  us  have  Health  Education  in  our  Teacher-Training  Col- 
leges that  will  aim  to  humanize,  to  warm,  to  vitalize.  Thus  we  can 
help  the  student  here  by  trying  to  render  as  innocuous  as  possible 
the  tensions  created  by  over-zealous  specialists  in  Latin,  history,  or 
mathematics — tensions  which  if  unrelieved  tend  all  too  often  to  seri- 
ously distort  the  student's  sense  of  values  besides  working  havoc  with 
her  nervous  system.  To  stabilize,  to  neutralize  fear  and  anxiety  will 
help  her  to  grow  mellow  instead  of  remaining  timid  and  callow. 

"The  term  'nervous  teacher'  has  come  to  be  almost  a  byword  in  fjow  t0 
our  schools  and  the  nervous  woman  with  the  querulous  voice  and  the  Eliminate 
irritable  ways  besides  laying  up  no  end  of  suffering  for  herself  could 
never  in  a  thousand  years  be  a  successful  teacher  of  Healthy  Living, 
It  is  well  to  remember  here  that  healthy,  happy  living  is  an  art 
as  well  as  a  science  and  no  amount  of  teaching  of  the  mere  cold 
facts  of  the  sciences  related  to  health  will  succeed  in  producing 
that  first  and  most  fundamental  necessity  in  Health  Education — a 
healthy,  happy  teacher.  If  you  were  psychoanalytically  inclined 
you'd  call  her  a  well  adjusted  personality — if  you  are  just  a  plain 
hygienist,  like  myself,  you'd  call  her  a  successful  practitioner  of 
the  fine  art  of  living.  This  to  me  is  the  most  subtly  difficult  aspect 


64 


A  Health 
Trium- 
virate. 


of  the  whole  job.  Just  exactly  by  what  means  it  shall  be  accomplished 
I  cannot  say.  I  have  only  the  profound  conviction  that  it  is  funda- 
mental and  must  be  done.  To  help  the  student  at  all  times  to  re- 
member that  she  is  first,  last  and  always  a  human  being — not  just 
so  much  raw  material  to  be  treated  with  alopathic  doses  of  various 
heavy  tasting  ologies  which,  instead  of  helping  to  interpret  life  to 
her  sometimes  at  least  serve  only  to  lead  her  further  and  further 
into  the  mazes  of  unreality.  'I'm  so  worried  over  Calculus  I  cannot 
sleep,'  or  'I'm  sure  I  shall  never  pass  History  3:'  not  all  the  fault 
of  the  college  curriculum — partly  the  student — immature  with  dis- 
torted perspective  and  faulty  sense  of  values — badly  in  need  of  edu- 
cation in  mental  hygiene — if  you  will. 

"The  second  aim,  really  embraced  by  the  first,  is  to  give  the  pro- 
spective teacher  the  Health  Ideal  energized  in  her  by  a  huge  wish 
for  accomplishment  both  in  herself  and  in  her  future  pupils.  When 
I  studied  college  psychology  we  used  to  say,  'Will.'  Now  I  under- 
stand it  is  'Wish';  will  or  wish,  it  must  be  strong.  The  Health  Ideal 
placed  before  her  must  be  that  of  'positive  health'  so  called.  She 
must  really  appreciate  and  understand  that  it  no  longer  suffices 
to  be  simply  not  sick — she  must  aim  to  be  always  gloriously  well. 

"The  third  aim  of  Health  Education,  here  has  to  do  with  the 
necessary  technical  information  and  equipment  which  will  enable 
the  student  to  first  maintain  her  own  health — both  mental  and 
physical — at  its  very  highest  level  and  second  the  information  which 
will  interpret  to  her  the  health  needs  of  her  pupils  together 
with  health  information  suited  to  their  needs  and  ages,  with  meth- 
ods thrown  in  if  you  like.  Personally  I  should  prefer  my  young 
teacher  of  health  ideals  to  be  thoroughly  well  and  happy  herself, 
generally  well-informed  along  health  lines  with  a  great  big  'Wish,' 
i.e.,  enthusiasm,  and  no  methods  (at  least  ready  made  ones), 
than  to  be  even  a  little  neurotic,  a  trifle  hollow-chested  but  method 
perfect.  Let  her  be  so  well  that  she  'oozes'  health  and  happiness 
then  I'm  sure  her  methods  will  take  care  of  themselves.  Ever  since 
my  own  normal  training  days  I'm  inclined  to  shy  from  methods  a 
little,  for  fear  the  trees  might  get  so  thick  we  couldn't  see  the  woods. 

"These  then,  being  some  of  the  fundamental  aims  of  Health  Edu- 
cation in  Teacher-Training  schools,  by  what  mechanisms  of  curriculum 
are  they  to  be  attained  or  approximated? 

"Narrowing  down  to  the  actual  department  organization  for 
health  work  which  has  met  with  most  favor  we  find  a  beneficent 
three-armed  influence. 

"The  first  arm  is  Health  Examination — gentle,  intimate,  leisurely, 
the  mental  as  well  as  the  physical  needs  of  the  student  being  con- 
stantly in  the  examiner's  mind — and  the  student  leaves  the  office 
haunted  by  no  gruesome  specters  of  disease  but  with  the  health 
vision  of  the  perfect  woman  she  wishes  to  be. 

"The  second  arm  takes  her  to  the  hockey  field,  to  the  swimming 
pool,  to  the  track  meet,  to  the  great  outdoors,  to  the  gymnasium. 
There  she  must  meet  personified  her  health  ideal  and  there  my 
constant  prayer  is — Oh  Lord  send  us  physical  education  leaders, 


65 

strong  and  clean  and  fine — and  many  of  them — and  oh!  Lord,  send 
them  quickly! 

"The  third  arm  gathers  her  into  the  classroom  and  lecture  hall 
to  hygiene  in  all  its  ramifications.  Careful  work  in  social  hygiene, 
heredity,  eugenics,  sanitation,  applied  bacteriology,  and  applied  physi- 
ology. Further  elaboration  of  subject  matter  is  aside  from  the 
point  here,  but  I  may  say  in  passing,  that  I  heartily  agree  with  Dr. 
Bigelow  that  if  you  wish  this  subject  matter  correlated  and  useful — 
have  it  given  in  your  own  department. 

"And  the  end  product  of  all  this?  We  dream  of  her;  we  have  not 
yet  produced  her, — quite.  A  warm,  vital,  happy  girl,  calm-eyed  and 
strong  and  gently  wise;  able  to  control  intelligently  all  that  pertains 
to  her  own  health,  and  ready  and  eager  to  do  her  part  in  guarding 
and  conserving  the  health  of  our  children." 

In  the  informal  discussion  following,  Dr.  Winslow  ex- 
pressed this  opinion: 

"The  newer  study  of  science  is  probably  the  best  way  to  approach 
the  subject  in  the  earlier  grades,  and  it  is  appropriate  to  call  it 
frankly  physiology  and  hygiene  in  the  upper  grades. 

"The  inculcation  of  proper  health  habits  is  the  objective  of  Health 
Education,  but  in  order  to  be  sound,  Health  Education  must  grasp 
the  underlying  principles  of  biological  behavior  in  the  broad  sense. 
Now  our  danger  is  that  in  the  reaction  from  the  old  system,  which 
gave  a  certain  amount  of  knowledge  about  the  body  and  did  nothing 
with  it,  we  may  attempt  to  do  something,  without  having  anything 
to  do  it  with.  There  is  no  antagonism  between  "Knowledge"  and 
"Health  Living,"  we  must  have  both,  and  if  our  Health  Education 
is  to  be  sound,  it  must  appeal  to  the  interest,  to  the  will,  and  to  the 
intellect  to  the  degree  to  which  the  child's  mind  is  attuned." 

Both  Miss  Mary  G.  McCormick,  Supervisor  of  Nutrition,  Student 
State  Department  of  Education,  Albany,  N.  Y.,  and  Miss  j^g 
Katherine  A.  Pritchett,  Supervisor  of  Nutrition,  Depart-  Scientific 
ment  of  Public  Instruction,  Pennsylvania,  in  substantiating  Knowled9e 
Dr.  Winslow's  point,  expressed  the  belief,  based  on  their 
observation  and  experience,  that  more  scientific  knowledge 
is  necessary  to  the  teaching  of  health,  and  that  our  teachers 
do  need  this  training. 

Miss  White,  however,  made  this  point: 

"There  are  many  schools  in  villages  and  rural  sections  where 
physiology  and  hygiene  are  taught,  but  where  there  are  no  special 
teachers  of  any  sort.  Granting  that  we  have  the  material  at  hand, 
but  that  it  needs  vitalizing,  we  have  an  opportunity  here  for  use 
in  Health  Education  which  we  ought  to  seize.  If  we  can  give  the 
teachers  the  help  they  need,  an  opportunity  offers  itself  for  teaching 
along  this  line  which  would  be  wasted  if  special  teachers  were,  in 
every  instance,  insisted  upon." 


66 

The  Chairman  next  introduced  Mrs.  Lucy  Paul,  Instruc- 
tor in  Bacteriology,  Physiology  and  Hygiene,  Pratt  In- 
stitute, Brooklyn. 

Place  of  Health  Education  in  the  Curriculum 

Mrs.  Paul: 

THIS  is  going  to  be  a  discussion  of  the  place  of  Health 
Education  in  the  High  School  and  Teacher-Training 
School. 

First  I  will  consider  it  in  the  High  School. 

The  student  now  has  left  the  realm  of  activity  without 
an  explanation  and  is  able  to  grasp  scientific  reasons.  We 
avoid  scientific  reasoning  with  a  young  child,  instructing 
him  in  health  habits  by  other  means,  both  at  home  and  in 
school.  But  at  the  High  School  age  the  child  begins  to  ques- 
tion the  "why  of  things."  As  soon  as  he  arrives  at  this 
period,  it  is  his  just  right  to  be  given  scientific  reasons  for 
an  explanation  of  his  question.  Therefore,  Health  Educa- 
tion should  be  taught  from  this  scientific  angle. 

But  the  knowledge  is  not  sufficient  unless  it  is  applied. 
This  combining  of  scientific  reasoning  with  the  practical 
application  of  it  lays  the  true  foundation  for  the  child's 
health  career.  Health  becomes  a  scientific  truth  to  him. 

As  many  complete  their  school  career  within  these  four 
years,  they  should  have  an  adequate  knowledge  of  how  to 
live  hygienically  before  they  leave. 

The  actual  teaching  falls  into  three  groups: 

(1)  The  Physical  Training  Department. 

(2)  Scientific  instruction  in  the  first  and  second  year 

of  High  School. 

(3)  Scientific  instruction  in  the  third  and  fourth  year 

of  High  School. 

The  Physical  Training  Department  should  give  hygiene 
talks  along  with  their  work  as  well  as  brief  instructions 
in  emergencies — this  last  being  very  important.  These 
talks  should  be  similar  each  year,  but  as  the  student  passes 
from  one  class  to  another  they  should  become  more  scien- 
tific. 

Now  we  have  come  to  the  second  group,  which  includes 
science  instruction  in  the  first  and  second  years  of  High 
School. 


67 

In  the  first  two  years  each  student  should  have  a  general  High 
idea  of  the  meaning  of  life  taught  through  biology  or  gen-  Hygiene 
eral  science.    In  general  sciences  emphasis  should  be  placed  Based  on 
upon  the  living  sciences,  particularly  human  physiology.  It  science. 
has  been  my  experience  in  teaching  general  science  that 
most  schools  wish  this  course  to  be  an  introductory  course 
to  chemistry  and  physics.    This  should  not  be  so  because 
the  living  sciences  are  of  greater  interest  to  a  student. 
Whenever  I  have  given  my  first  lesson  with  the  microscope 
I  never  have  known  it  to  fail  that  the  first  thing  the  stu- 
dents wanted  to  look  at  was  a  human  hair  or  the  human 
skin.    Living  objects  are  of  much  more  interest  to  children 
than  inanimate  things.    This  not  only  applies  to  children, 
but  to  mature  persons  as  well. 

Biology,  also,  should  place  emphasis  upon  human  physi- 
ology. The  student  should  be  taught  that  all  living  organ- 
isms possess  similar  systems  as  digestive,  circulatory, 
respiratory  and  excretory,  etc.  This  can  be  done  by 
taking  the  one-celled  animal  or  plant  and  have  the  students 
make  their  own  comparisons  between  these  and  the  gradual 
building  up  of  a  multicellular  organism  until  the  highest 
one  is  attained.  There  is  no  subject  which  brings  about  a 
more  logical;  reasoning  than  the  comparisons  of  living 
things,  noting  their  differences  and  tracing  their  similari- 
ties. 

If  physics  is  taught  in  these  first  two  years  many  hygiene 
lessons  may  be  put  in  here.  The  human  eye  is  an  excellent 
example  of  a  lens  and  the  hygiene  of  the  eye  is  easily  under- 
stood here. 

Also  in  chemistry  there  is  no  easier  way  of  teaching  Physics 
the  differences  between  the  chemical  and  physical  changes  ci^mistr 
in  the  first  lesson  than  by  showing  the  chemical  change  Contribute 
which  takes  place  in  food  when  acted  upon  by  enzymes,  etc.  to 
Every  student  knows  what  is  meant  by  a  sour  stomach, 
and  right  here  in  the  human  body  is  a  good  illustration  of 
alkalinity  and  acidity,  and  it  is  more  interesting  than  try- 
ing to  illustrate  these  two  properties  by  referring  to  chemi- 
cals of  which  the  student  has  no  knowledge. 

Lastly,  in  the  third  or  fourth  years  applied  physiology 
should  be  taught,  with  the  above  sciences  as  a  background ; 
the  differences  between  plants  and  animals  in  food  require- 
ments could  be  brought  out  as  well  as  the  reasons  for  dif- 
ferences in  their  digestive  systems,  etc.  This  course  should 


68 


All 

Physiology 
Should  Be 
Applied 
Phm 


Health 
Education 
at  Pratt. 


include  the  structure,  function  and  hygiene  of  each  organ 
in  a  general  way. 

Physiology  is  not  interesting  to  students  unless  it  is 
applied.  No  student  wishes  to  memorize  the  names  of  bones 
and  muscles  at  this  age,  but  they  are  interested  in  tracing 
food  through  its  digestion,  circulating  it  through  the  body 
as  blood,  tracing  it  to  the  cell  and  then  from  the  cell  through 
the  excretory  system  out  of  the  body. 

If  the  student  is  taking  a  commercial  course  he  should 
have  courses  in  emergencies,  biology  or  general  science  and 
applied  physiology.  No  student  should  ever  be  allowed  to 
leave  a  High  School  without  a  good  understanding  of  the 
"house"  which  he  must  always  occupy.  This  knowledge 
should  come  as  early  as  possible  through  science  courses. 

Sex  or  social  hygiene  should  come  within  these  four 
years,  and  perhaps  can  be  handled  best  by  the  Physical 
Training  Department. 

The  second  part  of  my  discussion  is  the  place  of  Health 
Education  in  a  Teacher-Training  School. 

Here  hygiene  education  should  first  give  the  student 
practical  knowledge  for  her  own  well-being  and,  secondly, 
knowledge  sufficient  to  teach  it  in  turn  to  her  students. 

As  an  instructor  of  Health  Education  at  Pratt  Institute, 
I  will  briefly  sketch  the  way  we  give  this  instruction  there. 

The  Physical  Training  Department  at  Pratt  gives  a 
course  of  personal  hygiene  lectures. 

Beginning  next  year,  in  addition  we  are  giving  an  emer- 
gency course  the  first  semester.  These  courses  are  closely 
allied  with  the  science  courses. 

The  first  year  the  students  have  an  applied  physiology 
course,  which  lasts  throughout  the  year.  Each  organ  of 
the  body  is  studied  from  the  standpoint  of  structure,  func- 
tions and  hygiene.  The  instructors  have  conferences  at 
which  each  student  is  discussed.  If  the  student  is  not  liv- 
ing a  hygienic  life  she  is  turned  over  to  the  physical  training 
instructor,  and  if  she  does  not  live  up  to  the  instructions 
given  she  is  told  that  she  cannot  be  recommended  for  a 
position,  even  though  her  scholarship  is  adequate  for  her 
certificate. 

In  the  second  and  third  year  an  intensive  course  of  ap- 
plied bacteriology  is  given  which  applies  to  everyday  life. 

The  microorganisms  of  milk,  water,  air  and  foods  are 
studied  and  then  the  student  is  encouraged  to  try  out  prob- 


69 

lems  which  she  is  interested  in.  One  of  the  students  this 
year  compared  the  bacterial  count  of  underclothing  which 
had  been  washed,  boiled,  dried  in  the  sunlight  and  ironed, 
with  the  silk  underclothing  which  cannot  be  washed  in  an 
alkali  and  hot  water  or  dried  in  the  sunlight  and  ironed 
with  a  moderate  iron.  The  results  proved  beyond  question 
that  the  silk  underclothing  retained  a  large  number  of  bac- 
teria from  the  human  body.  This  applied  bacteriology 
makes  the  student  realize  more  than  anything  else  the 
meaning  of  the  word  hygiene. 

After  the  completion  of  physiology  and  bacteriology  a 
home  and  community  course  of  hygiene  is  given  which  is 
a  resume  of  physiology  and  bacteriology,  and  also  includes 
social  hygiene,  mental  hygiene  and  hereditary  tendencies, 
etc. 

The  above  courses  are  closely  allied  with  the  courses  in 
chemistry,  physics,  cookery,  nutrition,  etc.    Whenever  we 
feel  a  subject  can  be  studied  to  better  advantage,  say,  for 
instance,  osmosis  in  the  physics  course,  we  put  it  in  that 
course.    When  I  take  up  lactic  acid  bacteria  in  bacteriology, 
the  chemistry  instructor  has  her  students  study  the  chemis-  Hygiene 
try  of  lactic  acid.     This  close  correlation  is  our  strongest  f^![ta5 
point.     While  I  am  taking  up  the  digestion  of  foods  in  of  All  the 
physiology,  the  instructor  of  chemistry  teaches  the  chemical  Scunces- 
composition  of  the  carbohydrates,  etc.     At  the  same  time 
the  preparation  of  the  different  food  stuffs  is  taken  up  in 
the  cooking  laboratory.     The  student  is  taught  the  same 
subject  matter  in  this  way  from  many  angles — that  is,  the 
digestion  of  foods,  their  chemical  composition,  their  prepa- 
ration and  their  application  to  the  health  of  the  body,  etc. 

If  we  have  a  student  who  is  underweight,  I  have  her 
write  out  her  menu  for  a  day,  and  the  class  as  a  whole 
criticize  it  for  her.  In  this  way  the  student's  health  is 
always  considered  first.  A  student  said  recently  that  no 
matter  where  she  was  at  Pratt  she  heard  hygiene — in  fact 
there  was  no  escaping  from  it. 

Correlation,  especially  of  hygiene,  is  absolutely  neces- 
sary to  make  science  courses  effective. 

Education  means  more  than  knowledge  to  us  now.  It 
means  the  right  thinking  and  the  right  living.  Every  stu- 
dent who  ever  has  attended  school  must  be  taught,  as  far  as 
it  is  possible  to  teach,  these  two  things — right  thinking  and 
right  living. 


70 


Teachers  must  set  the  example  and  unless  the  student 
applies  these  two  principles  to  her  own  life  we  teachers 
have  failed  in  our  teaching. 


Equal 
Rights 
for  All 
Subjects. 


Discussion 

The  discussion  was  begun  by  Miss  Marion  Lerrigo, 
Teachers'  College,  Columbia. 

"I  have  been  reminded  this  morning  of  a  most  startling  and 
remarkable  statement  that  came  to  my  notice  this  winter  in  one  of 
the  hygiene  papers:  'After  a  germ  gets  into  the  body,  it  swells  and 
swells  and  swells,  until  it  gets  into  the  whole  system,  and  then  you  have 
the  disease.'  It  seems  to  me  that  at  Pratt,  Health  Education  seems  to 
have  swelled  into  the  whole  system  until  they  now  have  an  interesting 
and  beautiful  case  of  the  disease. 

"Health  Education  should  permeate  our  whole  educational  system, 
including  the  relationship  of  teachers  to  pupils,  medical  inspection, 
school  buildings,  school  lunches,  school  management,  as  well  as  cur- 
riculum, so  that  we  might  almost  say,  'The  place  of  the  curriculum 
in  Health  Education*  instead  of  'The  place  of  Health  Education  in 
the  curriculum/  However,  as  practical  people,  we  have  to  get  Health 
Education  into  the  subjects  of  the  curriculum  and  there  are  two  points 
which  the  talks  this  morning  have  suggested  to  me  that  I  wish  to 
make. 

"I  do  not  wish  to  be  disrespectful  at  all,  but  this  Conference 
yesterday  reminded  me  of  an  octopus  spreading  out  its  arms  into 
almost  all  the  fields  of  science  and  trying  to  take  out  the  parts 
relating  to  Health  Education  and  assemble  them  together.  The  prob- 
lem is,  where  are  we  going  to  put  all  the  knowledge  we  assembled 
yesterday?  Mrs.  Paul  told  us  about  Pratt  and  her  work  there  in 
bacteriology,  physiology  and  hygiene.  I  am  particularly  impressed 
with  the  point  that  she  made:  Last  year  or  the  year  before  certain 
subject  matter  was  included  in  bacteriology,  the  next  year  in  chemis- 
try, etc.  I  wish  we  might  apply  that  principle  all  the  way  through, 
from  the  Kindergarten  up. 

"It  is  extremely  difficult  to  say  whether  a  part  of  Health  Education 
is  more  effective  in  English,  in  geography,  science,  home  economics, 
or  physical  education.  I  believe  that  the  only  way  we  will  arrive 
at  very  definite  conclusions  is  from  just  such  experimentation  as 
was  made  there. 

"The  other  point  that  I  wish  to  make  is  this.  If  the  civics  teacher, 
for  instance,  had  been  here  this  morning,  or  the  dramatics  teacher,  she 
would  have  been  appalled  that  Health  Education  specialists  should 
annex  these  subjects  for  the  purpose  of  teaching  health.  There  is 
a  place  in  the  curriculum  for  other  things  besides  Health  Education, 
and  I  want  to  make  this  plea:  When  we  use  English,  or  use  arith- 
metic, or  use  dramatics  in  Health  Education,  let  us  observe  the  rights 
and  personalities  of  those  subjects  themselves.  We  have  no  right, 


71 

even  in  as  important  a  matter  as  Health  Education  is,  for  example, 
to  teach  health  through  a  health  play  as  atrocious  from  the  dramatic 
point  of  view  as  some  of  the  health  plays  have  been.  So  I  wish 
finally,  just  to  repeat  these  two  points,  a  plea  for  experimentation 
in  health  teaching,  and  a  plea  for  respecting  the  personality  of  the 
other  subjects  in  the  curriculum." 

These  remarks  provoked  some  lively  discussion,  started 
by  Mr.  Chase,  who  said :  "Apropos  of  respecting  the  per- 
sonality of  subjects  and  their  proper  place  in  the  curricu- 
lum, may  I  say  that  we  are  not  teaching  subjects,  but  are 
teaching  children?" 

Dr.  Winslow: 

"You  are  not  teaching  subjects;  you  are  not  teaching  children. 
You  are,  I  hope,  teaching  subjects  to  children." 

Dr.  Wood: 

"May  I  offer  a  paraphrase  to  Dr.  Winslow's  emendation  of  Mr. 
Chase's  statement,  that  we  really  ought  to  be  helping  children  to 
train  themselves  by  the  use  of  subjects." 

Dr.  Small: 

"We  want  to  stick  to  the  doctrine  that  we  are  teaching  children   A  Question 
by  means  of  subjects  and,  more  important,  we  are  teaching  them  by   of  Defini- 
means  of  or  through  activities.     The   real   difference   between   the    lons' 
modern  progressive  education  and  the   old  traditional  education  is 
right  there. 

"Now,  the  correlations  that  we  are  making  in  Health  Education 
may  be  failures  or  they  may  be  very  fundamental  and  sound.  In  an 
ancient,  mediaeval  book,  there  is  an  example  of  the  kind  of  correlation 
that  we  wish  to  avoid,  though  it  is  often,  alas,  found  even  today: 
'Johnny  caught  a  fly;  he  pulled  off  six  legs  and  two  wings — How  many 
legs  and  wings  had  the  fly?  What  a  wicked  boy  was  Johnny!1 " 

Miss  Julia  Wade  Abbot,  Specialist  in  Kindergarten  Edu- 
cation, Bureau  of  Education,  Washington,  D.  C.,  added  the 
following  story,  bringing  out  an  important  point.  She  said : 

"The  great  difficulty  in  teaching  children  through  their  own  activ- 
ities is  that  we  do  not  know  whether  we  have  got  the  thing  over. 
We  are  the  pipers  and  the  children  dance.  I  will  illustrate  this 
point  by  the  following  story:  An  aesthetic  art  teacher  had  a  class 
of  children;  she  thought  she  had  the  best  methods,  and  used  the  most 
beautiful  colors,  etc.  The  children  used  these  through  their  own 
activities.  She  thought  she  had  developed  an  appreciation  in  the 
children  of  art,  and  was  really  confirmed  in  that  opinion,  when,  at 
Christmas  time,  they  gave  her  a  copy  of  Mona  Lisa.  But  somebody 
had  been  in  the  shop  when  the  selection  had  been  made  and  this  is 
what  she  heard:  'Teacher  loves  muddy  colors,'  said  one  of  the  children; 


72 


'let  us  find  the  ugliest  picture  we  can.    Here  is  a  picture  of  a  homely 


woman. 


Three 

Points  in  a 
Health 
Education 
Program. 


Dr.  Bigelow: 

"While  we  are  teaching  children  through  subjects,  according  to 
Doctors  Wood  and  Small,  I  hope  we  will  teach  them  some  subject 
matter,  through  facts,  according  to  Dr.  Winslow." 

The  Chairman  next  introduced  Miss  Emma  Dolfinger, 
Associate  Director  of  the  Child  Health  Organization,  and 
recently  Supervisor  of  Science  in  the  Elementary  Schools, 
Louisville,  Ky.,  who  spoke  on 

The  Place  of  Health  Education  in  Elementary  Schools 

Miss  Dolfinger: 

THE  contents  of  the  paper  which  I  have  the  privilege  of 
presenting  to  you,  is  the  outcome  of  several  years*  ex- 
perimentation in  teaching  health  in  some  sixty  elementary 
schools  of  varying  social  and  physical  environment,  and  the 
chief  reason  for  giving  this  talk  is  that  this  account  may 
provoke  discussion  which  will  help  to  clear  up  some  of  the 
questions  awaiting  solution. 

The  experiment  in  Louisville  passed  through  two 
stages, — first,  the  propaganda  stage, — to  interest  teachers 
and  to  capture  their  imaginations;  and  second, — the  stage 
in  which  it  now  is,  namely,  where  the  need  is,  to  keep  the 
enthusiasm  and  activity,  but  to  guide  it  so  as  to  give  it 
organic  form  and  to  affiliate  health  teaching  with  elemen- 
tary science. 

There  seem  to  be  three  necessary  points  to  be  developed 
in  a  Health  Education  program.  The  first  point  is 
opportunity  for  children  to  practice,  or  report  on  home 
practice  of  health  duties,  together  with  the  opportunity 
to  acquire  training  in  the  proper  technique  of  health 
habits.  By  this  is  meant  that  children  must  be 
taught,  either  at  home  or  at  school,  how  to  do  these 
health  activities  in  such  a  way  as  to  acquire  their 
full  benefits.  Such  things  as  tooth  brush  drills;  breath- 
ing exercises;  standing,  sitting  and  walking  properly; 
choosing  proper  meals  in  the  lunch  room;  and  eating 
them  properly  are  some  of  the  situations  where  nurse  or 
teacher  can  see  that  health  activities  are  correctly  per- 


73 

formed.    All  of  these  must  have  as  basis  the  developing  of 
enthusiasm  for  such  practice. 

The  second  point  in  the  health  program  consists  in  Successful 
giving  the  child  an  enlightened  attitude  towards  hygiene  Teaching 
and  sanitation.    This  phase  means  giving  information  and  Enthu- 
ideals  through  the  usual  channels  of  books,  trips,  pictures,  siasm- 
and  so  on.     It  is  important  to  do  this  in  a  live  way,  by 
appeals  to  the  children's  true  interests.    Success  here  again 
has  as  a  basis  the  development  of  enthusiasm  for  health. 

The  third  important  goal  is  providing  conditions  in  the 
school  environment,  at  least,  which  make  the  correct  im- 
pression in  order  to  strengthen  the  bonds  we  are  striving 
to  form.  Conditions  that  are  important  are  adequate  lava- 
tory conveniences,  gymnasiums,  well  conducted  lunch 
rooms,  hygienically  arranged  programs,  adequate  nursing 
and  medical  service,  and  so  on  through  the  program  of  all 
those  activities  accessory  to  a  modern  school  program. 

Over  the  first  two  parts  of  the  program  mentioned  the 
classroom  teacher  has  control.  The  third  part,  for  which 
she  is  dependent  on  other  people,  can  by  its  absence,  make 
her  efforts  very  hard  of  fulfilment.  The  usefulness  of 
Parent-Teacher  Associations,  in  getting  good  conditions, 
has  not  been  exploited  as  much  as  it  might  be. 

With  the  foregoing  point  of  view,  it  is  evident  that  Health 
Health  Education  cannot  be  confined  to  one  place,  —  it  must  Teaching 
permeate  the  curriculum.    To  do  this  effectively,  there  must  Permeate 


be  both  a  definite  place  in  the  program  for  certain  specific 
health  activities,  and  fully  thought-out  correlation,  since  ulum. 
health  instruction  is  more  effective  for  being  given  from 
many  points  of  view. 

Definite  time  assignments  which  must  be  planned  for, 
and  which  cannot  be  left  to  chance  or  to  merely  possible 
correlations,  include  the  following: 

First,  daily  inspection  or  some  form  of  health  habit 
accounting  and  some  constructive  use  of  the  findings. 

Second,  regular  time  for  weighing  and  measuring, 
with  discussion  and  use  of  the  data  as  a  basis  for  later 
health  work. 

Third,  physical  training  with  corrective  work  for  those 
who  need  it,  in  addition  to  organized  or  free  play. 

Fourth,  weekly  lessons,  well  planned  and  motivated  in 
the  grades  above  the  fourth,  at  least. 


74 


Planning 

Lessons 

Around 

Child 

Interests. 


The  aim  should  be  for  scientific  as  well  as  for  ethical  or 
mannerly  concepts,  but  throughout,  such  instruction  should 
be  kept  on  the  "play  level."  The  lesson  series  should  be 
grouped  about  real  problems,  such  as  "How  can  we  bring 
up  our  weight  to  normal,  and  what  are  the  reasons  for  these 
steps?"  "What  are  the  reasons  for  the  rules  given  us  for 
caring  for  our  teeth?  What  can  the  class  do  to  make  a  100 
per  cent,  record  for  sound  teeth?"  "What  can  science  teach 
us  that  will  help  the  boys  score  well  in  the  Athletic  Con- 
test?" "How  much  of  the  food  advertising  in  the  magazines 
is  really  true?" 

Such  questions  have  led  to  sound  health  lessons  with 
simple  but  sound  science  behind  them.  The  unusual  op- 
portunities here  for  training  in  English  expression  are  too 
obvious  for  discussion.  Trips,  experimentation,  demon- 
stration, are  preliminary  to,  or  concurrent  with,  reading, 
oral  and  written  expression,  as  means  of  obtaining  subject 
matter. 

An  important  subject  for  consideration  in  a  discussion 
of  the  place  of  Health  Education  in  the  curriculum,  is  the 
opportunity  for  correlation.  Opportunities  legitimately 
occur  in  the  use  of  other  subjects  as  tools,  when  a  live 
health  idea  is  to  be  put  across.  English,  art,  arithmetic, 
manual  training,  home  economics,  may  be  so  used.  Often 
the  reverse  is  true,  as  when  unconsciously  to  the  children, 
but  never  to  the  teacher,  geography,  history,  literature, 
even  statistical  mathematics,  may  introduce  or  develop  a 
health  project,  a  health  ideal,  or  a  health  message.  For 
example,  in  the  study  of  geography,  health  subjects  must  be 
considered  in  such  topics  as  food  industries,  textile  in- 
dustries, water-power,  water  supplies  and  their  conserva- 
tion, the  Panama  Canal,  and  so  on  with  many  of  the 
geographical  topics  included  in  the  course  of  study.  Oppor- 
tunities arise  in  history,  in  the  study  of  the  civilization  of 
the  Greeks,  the  living  customs  of  the  Middle  Ages,  the  con- 
trast of  colonial,  pioneer,  and  primitive  life,  with  that  of 
today.  Biography  offers  us  the  stories  of  Pasteur,  Roose- 
velt, Stevenson,  with  the  great  health  message  of  those 
lives. 

In  short,  the  great  problem  is  to  get  the  teacher  to  set 
her  health  problems  for  herself,  adapting  them  to  the  needs 
of  her  group, — and  then  to  take  stock  of  the  opportunities 
her  entire  curriculum  offers  for  solving  this  problem.  Such 


75 

procedure  will  result  in  real  correlation.  To  help  develop 
this  type  of  work  is  the  great  opportunity  of  supervisory 
officers  and  the  obligation  of  the  Normal  School.  To  bring 
out  examples  of  health  activities  truly  correlated  with  other 
subjects  in  the  curriculum,  is  the  purpose  of  the  discussion 
that  follows;  hence,  time  will  not  be  taken  to  do  this  now. 

Finally,  let  me  say  a  word  about  the  help  that  is  due  the 
classroom  teacher,  who  has  to  execute  the  plans  and  ideas 
above  outlined.    Her  supervisor  owes  her  guidance  accord- 
ing to  her  training  and  experience.    The  supervisor  must 
make  her  thrill  to  health  ideals  for  herself,  as  well  as  for 
her  pupils.    The  supervisor  must  put  her  in  touch  with  the  Super- 
substance  of  professional  literature  (subject  matter),  and  obligations 
with  current  methods  of  health  teaching  in  a  stimulating  to  Her 
and  easy  way.     The  supervisor  must  provide  her   with     eac  ers' 
material,  encouragement,  and  wise  guidance.     The  super- 
visor must  devise  ways  to  help  the  teacher  evaluate  her 
work  and   eliminate  unproductive   efforts.     Finally,  this 
supervisor  should  stimulate  and  give  publicity  to  whatever 
the  teaching  force  produces,  that  is  good. 

Enthusiasm  for  Health  Education  derived  from  a  sound 
knowledge  and  joyous  healthy  living  must  be  in  the  teacher, 
before  it  can  get  into  the  children's  lives, — no  matter  what 
its  theoretical  place  in  the  curriculum. 

Discussion 


To  lead  the  discussion  of  this  paper,  Dr.  Wood  presented 
Miss  Mary  Moriarty,  a  teacher  in  Public  School  No.  158, 
New  York  City,  as  the  author  of  a  most  fascinating  guide 
book— "Many  Roads  to  Health." 

Miss  Moriarty  said : 

"In  listening  to  Miss  Dolfinger's  paper  one  thing  that  appealed 
to  me  was  the  matter  of  giving  the  child  an  opportunity  to  report 
on  the  home  practice  of  his  health  duties. 

"In  communities  of  a  foreign  nature  the  child  who  goes  to  school 
and  who  speaks  English  plays  an  important  part  in  the  home.     He 
is  a  guide  to  the  clinics  and  hospitals  and  does  a  large  part  of  the   Children  as 
shopping.     He  decides  upon  the  stores  to  be  patronized.     The  knowl-    Teachers  in 
edge  the  child  gets  in  school  is  greatly  depended  on  by  the  parents.   Foreign 
The  child  should  know  what  constitutes  a  proper  meal,  how  to  lay  Homes. 
a  table,  etc.,  and  that  it  is  poor  economy  to  patronize  a  dirty  store. 

"In  homes  of  foreign  communities,  the  parents  often  express  sur- 
prise at  the  ease  with  which  the  teacher  succeeds  in  getting  the 


76 

children  to  do  things,  such  as  brushing  their  teeth,  drinking  milk, 
going  to  bed  at  a  proper  hour,  etc.  In  New  York  State  the  nurses, 
doctors  and  school  officials  depend  upon  a  classroom  teacher  to 
carry  certain  points  over  to  the  parents,  who  are  proving  hard  to 
convince.  In  teaching  health  in  a  live  way  I  have  found  playing  the 
game  one  of  the  best  methods.  It  at  once  catches  the  imagination 
and  puts  the  child  on  the  track  of  receiving  further  health  instruction. 
"After  the  children  know  that  apples  are  a  good,  healthful  kind 
of  food  and  good  regulators  of  the  body  they  enjoy  making  posters 
showing  apples  with  faces,  legs  and  arms.  Dr.  Wilkes  proved  that 
beyond  a  shadow  of  a  doubt  in  Trenton.  The  posters  are  made  neatly 
and  not  in  a  slovenly  fashion;  they  are  taken  home  and  placed  on 
the  walls  and  the  parents  enjoy  them  too. 

"Health  should  not  be  confined  to  one  place.  The  teaching  of 
health  does  not  constitute  a  divorce  between  health  subjects  and  the 
ordinary  subjects  of  the  classroom,  but  lends  itself  in  a  fascinating 
way  to  the  teaching  of  English,  both  written  and  oral.  For  instance, 
if  a  teacher  decides  on  a  composition  on  'Milk,'  and  puts  the  children 
in  possession  of  the  facts — how  much  milk  they  should  drink  and 
how  they  should  drink  it,  etc.,  if  the  teacher  should  decide  that  this 
sort  of  composition  will  prove  in  the  long  run  more  useful  to  the 
children  than  compositions  on  such  subjects  as  'I  Wish  I  Were  a 
Lion/  'The  Violets,'  'An  Autumn  Sunset,'  'How  I  Spent  My  Vacation,' 
etc.;  if  she  decides  that  this  composition  on  'Milk'  will  help  the 
children  as  much  as  the  other  subjects,  then  she  should  go  ahead  and 
substitute  her  composition  on  'Milk'  and  proceed  in  the  usual  way. 
The  procedure  is  identical,  except  that  the  children  will  show  much 
more  originality  and  a  desire  to  express  themselves. 

A  Health  "In  my  classroom  we  run  a  paper  called  'The  Health   Edition.' 

Newspaper.  All  that  is  needed  is  some  children  and  some  drawing  paper.  This 
little  paper  comes  out  every  month  and  is  in  great  demand  all  over 
the  building.  It  is  a  side  line  and  the  children  do  it  at  home  and  at 
extra  periods  when  their  work  is  finished.  One  boy  is  editor-in-chief. 
Other  boys  are  assistants,  and  the  rest  of  them  are  reporters,  and 
I  was  appointed  assistant  editor,  I  must  say,  much  to  my  surprise. 
Sometimes  the  children  bring  in  very  good  articles,  but  they  cannot 
be  published,  because  they  are  not  properly  spelled  or  are  badly 
punctuated.  The  reasons  why  they  cannot  be  published  are  pointed 
out.  Then  the  child  will  get  out  his  dictionary  from  the  bottom  of  his 
desk  where  it  reposes  most  of  the  time,  and  he  will  get  the  brighter 
members  of  the  class  interested,  and  after  a  while  the  article  comes 
back  correct. 

"Next  term  I  decided  to  let  the  children  write  their  own  supple- 
mentary readers.  This  occurred  to  me  when  I  saw  how  nicely  a  boy 
had  written  a  short  story  and  how  fascinated  the  other  children  were 
by  it,  and  how  interested  they  were  in  reading  it,  even  more  so 
than  if  it  had  been  published  by  the  Macmillan  Company. 

"In  the  formal  work  of  an  ordinary  classroom  much  time  is  devoted 
to  teaching  the  importance  of  punctuation.  This  can  be  taught  in 
its  health  relationship.  In  dictation  exercises,  the  teacher  can  ask 
the  children,  'How  many  of  you  were  in  bed  last  night  at  eight 


77 

o'clock?  Were  the  windows  open?'  The  period,  the  interrogation 
mark  are  entirely  recognizable  by  the  children.  Results  will  be 
obtained. 

"History  work  presents  many  places  in  which  there  can  be  correla-   Correlation 
tion  with  health  work,  as  in  the  part  that  health  played  in  the  lives 
of  the  great  heroes,  Daniel  Boone,  Kid  Carson,  etc.     In  the  arith- 
metic  work  also,  every  teacher  who  has  taught,  knows  how  hard  it  Arith- 
is  to  teach  the  child  to  use  a  ruler  intelligently.    A  margin  of  */2  inch   metic. 
or  J/4  inch  means  exactly  the  same  to  them.     An  VB  of  an  inch  does 
not  exist  for  them.     When  you  put  a  tape  line  up  against  the  wall 
and  they  start  taking  each  other's  height,  in  ten  minutes  every  boy 
in  school  can  measure  most  accurately.     You  will  hear  one  of  them 
say,  'He  is  skinning  me  out  of  %   of  an  inch  on  my  height.'     The 
same  with  the  scales.     One-eighth  assumes  a  very  important  place. 
Many  problems   may  be  prepared   dealing  with   quantities  of  milk 
drunk,  the  weights  of  the  class,  etc. 

"The  teacher  expects  to  use  every  effort  to  bring  the  children 
up  to  grade.  She  should  know  how  many  children  are  coming  to 
school  habitually  dirty,  how  many  are  using  bad  postures.  She  ought 
to  be  able  to  detect  the  'ten  o'clock  scholar'  by  the  shadows  under  the 
pupil's  right  eye,  without  being  so  terribly  learned. 

"These  defects  of  vision  and  hearing,  of  children  suffering  from 
chorea,  malnutrition,  etc.,  and  her  skill  in  getting  them  corrected, 
should  show  up  to  her  credit  the  same  as  it  would  in  balancing  up 
the  deficiencies  in  any  other  subject. 

"A  class  inspection  for  30  children  takes  exactly  five  minutes,  and 
the  children  look  forward  to  it.  I  forgot  it  when  we  were  terribly 
rushed  one  day,  and  a  little  voice  piped  up:  'Aren't  you  going  to 
look  at  us  this  morning?' 

"If  a  boy  comes  to  school  dirty,  don't  fuss  about  it  too  much. 
Treat  it  the  way  you  would  treat  any  accident.  Just  say  'John, 
wash  yourself  before  you  sit  down  to  the  table.'  He  takes  a  bar  of 
soap  and  a  towel  and  goes  out.  Next  morning  he  comes  to  school 
clean. 

"In  homes  where  the  mother  is  dead  and  the  boy  of  13  takes  cares 
of  himself,  or  where  the  mother  is  out  working  all  day  and  the  boy 
apologizes  for  his  blouse  not  being  washed,  because  the  mother  has 
mislaid  the  flatiron — when  that  boy  gets  seven  points,  it  is  not  just 
a  happening,  it  is  a  victory. 

"At  the  end  of  the  month  the  points  are  counted  up,  and  the 
boy  who  gets  the  greatest  number  of  points  gets  a  tangible  reward. 
It  is  not  given  as  an  objective  at  all,  but  as  a  form  of  recognition 
for  distinguished  achievement." 

Miss  Abbot: 

"I  want  to  know  how  Miss  Moriarty  received  her  enthusiasm.  How 
did  it  come  to  her  as  a  public  school  teacher?" 

Miss  Moriarty: 

"Well,  I  received  that  enthusiasm  from  the  Child  Health  Organi- 
zation." 


78 


Returning  to  the  discussion  of  where  and  how  the  sub- 
ject matter  should  be  taught,  Miss  Effie  Knowlton,  Super- 
intendent of  Health  Education  Department,  Department  of 
Education,  Binghamton,  N.  Y.,  said  that  from  her  ex- 
perience in  Binghamton,  she  felt  that  much  loss  of  time 
and  overlapping  in  handling  a  Health  Education  pro- 
gram was  prevented  by  placing  the  work  in  the  hands  of 
the  classroom  teacher,  who  could  correlate  the  many 
Health  Education  activities  with  the  other  school  subjects. 
To  do  this  successfully  the  teacher  needs  the  assistance  and 
supervision  of  the  specialists  on  the  education  staff,  who 
in  turn,  should  work  in  close  cooperation. 

Dr.  Franklin  Barrows,  Assistant  State  Medical  Inspec- 
tor of  Schools,  State  Department  of  Education,  Albany, 
N.  Y.,  then  described  as  follows  the  program  of  Health 
Education  which  the  State  Department  of  Education  has 
been  promising  to  the  teachers  of  New  York  State  for  some 
years  back,  and  which  will  probably  be  distributed  this 
fall.  He  said : 

The  "The  syllabus  has  been  completed  through  the  6th  grade  and  we 

New  York  hope  and  contemplate  that  it  will  be  possible  to  continue  the  syllabus 
Syllabus  in  through  the  7th  and  8th  grades  to  the  High  School.  I  must  speak  then 
of  our  plan  as  carried  out  to  date. 

"The  one  thread  that  runs  through  this  syllabus  from  beginning 
to  end  is  the  formation  and  practice  of  health  habits.  That  unites 
one  lesson  to  another  and  one  year  to  another  and  forms  the  theme, 
and  there  are  plenty  of  health  habits  to  be  instilled  into  the  children. 
"We  also  present  with  these  health  habits  a  sufficient  amount 
of  information — and  by  information  we  mean  material  that  may 
come  under  the  head  of  physiology  or  function  or  anatomy  or  struc- 
ture, although  we  do  not  use  the  label  of  physiology  or  anatomy 
for  the  matters  that  are  presented  in  this  way — and  some  'Safety 
First*  teaching.  Safety  First  is  as  important  as  the  formation  of 
any  other  health  habit. 

"Our  aim  is  also  to  present  to  the  child  before  the  end  of  the 
6th  grade  all  the  material,  all  the  information,  which  in  our  opinion 
it  is  possible  for  him  to  learn  and  utilize  up  to  the  end  of  the  6th 
grade.  We  have  exercised  care  not  to  present  any  material  too  far 
advanced  for  6th  grade  pupils.  We  have  taken  special  pains  not 
to  make  the  lessons  too  long — a  syllabus  jammed  too  full  is  worse 
than  none  at  all.  It  confuses  the  teacher  and  makes  her  work  doubly 
hard  in  having  to  select  from  it  what  she  can  do  and  pass  the  rest  by. 
We  have  tried  to  make  each  lesson  a  possible  lesson  with  a  possible 
class,  and  a  teacher  that  is  sometimes  almost  impossible.  I  wish 
we  were  talking  about  teachers  instead  of  syllabi  and  pupils.  The 
syllabus  is  worked  out  with  the  idea  that  the  child  will  leave  school 
at  the  end  of  the  6th  year.  Many  do  not  return  after  that.  That 


Health 
Education. 


79 

child  has  had  a  complete  course  in  hygiene,  with  physiology  and 
anatomy.  He  will  be  well  fitted  for  life,  without  any  more  schooling, 
as  a  school  can  possibly  make  him. 

"If  we  have  the  privilege  of  introducing  a  syllabus  for  the  Junior 
and  Senior  High  Schools,  what  else  shall  we  teach,  except  the  same 
thing  in  an  advanced  form?  We  have  a  whole  syllabus  from  Kinder- 
garten up  to  end  of  6th  grade.  The  syllabus  is  progressive.  We  have 
to  repeat  certain  material  several  times.  Many  habits  are  repeated, 
but  each  time  the  habit  is  repeated  it  is  repeated  in  an  advanced 
way  for  a  child  of  somewhat  better  mental  equipment  than  the 
child  who  had  the  same  lesson  a  year  or  six  months  before.  In  the 
7th  and  8th  grades  new  material  is  presented — new  health  habits 
may  be  presented  with  very  great  effect — and  you  may  call  it  a 
review  of  physiology  and  hygiene  in  more  advanced  form." 

Miss  Gertrude  Whitton,  Department  Health  Develop-  The  Oak- 
ment,  Oakland  Public  Schools,  Oakland,  California,  then  of-  land  P^n. 
f ered  for  consideration  a  plan  being  tried  out  in  Oakland  to 
determine  the  proper  distribution  of  health  practices  and 
subject  matter  through  the  grades.  According  to  this 
plan  teachers  in  the  field  were  compiling  lists  of  the 
knowledge  and  activities  relating  to  health  which  seemed 
to  be  appropriate  at  the  various  ages.  This  material  they 
hoped  would  assist  them  to  allocate  the  distribution  of 
health  instruction  on  a  sounder  basis  than  was  being  done 
at  the  present  time. 

Professor  C.  E.  Turner,  Assistant  Professor,  Depart- 
ment of  Biology  and  Public  Health,  Massachusetts  Institute 
of  Technology,  commented  on  the  value  of  experimentation 
in  Health  Education  programs,  as  follows: 

"All  the  different  programs  or  experiments  which  can  be  carried 
out  in  different  communities  are  going  to  be  useful  to  us.  I  have 
thought  of  the  conditions  which  have  been  mentioned  in  some  of 
the  cities  as  compared  with  conditions  in  Maiden,  where  we  are 
using  the  first  four  grades  for  informal  health  work.  We  have 
formal  instruction  in  the  5th  grade,  continuing  through  to  the  6th, 
adding  in  the  7th  a  knowledge  of  community  hygiene;  in  the  8th, 
first  aid  and  home  nursing;  in  the  9th,  practical  applied  physiology. 
This  may  not  be  the  best  thing  for  many  communities  or  the  best 
thing  for  us,  but  it  seems  to  be  the  logical  program  at  the  present 
time. 

"One  of  the  things  we  are  looking  after  in  the  elementary  grades 
is  the  biting  of  finger  nails  by  children.  We  can  practically  eliminate 
bad  habits  in  that  respect  in  the  2d  grade  in  about  six  or  eight 
weeks,  whereas  in  the  5th,  6th  and  7th  grades  it  is  almost  impossible 
to  stop  that  habit — it  has  become  so  fundamental  a  habit  on  the 
part  of  the  child. 


80 


Many 

Possible 

Health 

Programs 

Safer  Than 

One. 


Pre-School 
Child 
Health 
Conferences 
in  Texas. 


"We  have  found  it  can  be  done  a  little  better  in  one  place  than 
another.  As  we  are  all  studying  material  and  placing,  we  are  going 
to  come  into  this  zoning  period,  but  I  am  particularly  pleased  that  we 
are  developing  our  discussion  in  such  a  way  that  we  are  going  to 
bring  out  a  large  group  of  possible  programs  from  which  we  are 
going  to  select.  I  believe  we  are  on  safer  ground  than  if  we  try 
to  develop  one  program." 

Miss  Jeanie  Pinckney,  Department  of  Home  Economics, 
University  of  Texas,  Austin,  Texas: 

"Why  wait  until  the  child  enters  the  school  before  we  have  a  defin- 
ite program  in  the  community?  Why  wait  until  bad  habits  develop  be- 
fore we  do  anything?  Why  cannot  we  have  a  prevention  of  bad  habits 
as  well  as  a  prevention  of  other  things?  Why  not  warn  the  mother 
beforehand  what  is  the  thing  that  is  going  to  happen  to  her  child  ?  Why 
not  warn  her  that  the  child  v/ill  cry  for  food  that  it  should  not  have? 

"In  Texas,  we  give  a  program  in  the  different  communities — a 
Child  Health  Conference.  The  mother  has  to  ask  for  an  appoint- 
ment; we  never  take  children  except  by  appointment.  A  record  is 
given  to  the  mother  and  only  the  defects  observed  in  the  child  are 
recorded  as  it  is  the  purpose  of  the  examination  to  center  the  mother's 
attention  on  the  child's  needs,  and  in  the  long  run  that  is  what  she  is 
coming  to  the  conference  for. 

"We  are  trying  to  get  the  children  into  perfect  physical  fitness 
before  they  enter  school.  We  not  only  correct  defects  but  do  as 
much  preventive  work  as  possible.  The  dentist  does  only  preventive 
work,  and  if  he  does  not  find  any  defects  he  takes  time  to  tell  the 
mother  about  future  teeth,  and  he  never  fails  to  tell  her  about  the 
six-year  molar." 

Dr.  Edwards,  School  Dentist,  Board  of  Education, 
Trenton,  N.  J.,  rose  to  speak  of  the  importance  of  placing 
early  in  the  grades  the  beginnings  of  oral  hygiene  teaching. 
He  said  that  owing  to  the  tremendous  importance  of  the 
six-year  molar,  such  educational  work  should  begin  at  the 
earliest  possible  moment,  i.  e.,  in  Kindergarten.  He  stressed 
two  factors  as  being  essential  to  producing  good  teeth. 

(1)  Proper  diet — beginning  with  pre-natal  life. 

(2)  Proper  care,  including  prophylaxis  and  repair. 

Miss  Mary  A.  S.  Mug  an: 

"Being  the  assistant  superintendent  in  one  of  the  textile  districts, 
Fall  River,  Mass.,  where  one  comes  in  contact  with  the  class  of 
parent  described  by  Miss  Moriarty,  one  realizes  that  the  education 
for  the  preservation  of  the  six-year  molar  and  for  many  other 
things,  must  begin  earlier  than  the  Kindergarten. 

"It  must  begin  with  the  mothers.  We  hope  that  the  children  we 
are  teaching  now  will  be  intelligent  mothers  in  the  future,  but  we 
cannot  wait  for  that  time.  We  must  get  hold  of  the  mothers  of 


81 

these   children  by   mother-classes   in   connection   with '  Kindergarten   Massa- 
and  school,  especially  for  working  mothers.    All  school  systems  should   chusetts 
make  provision   for  the  instruction   of  mothers.     So,   through  wise   a^^[ 
legislation  in  the  Commonwealth  of  Massachusetts,  the  Public  School   Mother 
Department  is   allowed  to   organize  classes   for  mothers  under  the   Classes. 
direction  of  the  School  Department.     These  classes  are  State-aided. 
For  every  cent  that  we  spend,  the  State  pays  one-half  of  the  cost  of  the 
classes,  if  we  bring  them  up  to  the  State  standard,  which  is  very  high. 
We  have  classes  for  mill  women  in  the  evenings  in  our  public  schools. 
We  have  trained  nurses  carefully  selected  to  give  courses  to  these 
women,  and  there  was  so  great  a  demand  for  the  courses  that  we 
had  to   stop   them  on   account  of   insufficient  nurses." 

Dr.  Wood,  in  concluding  the  morning's  discussions, 
said: 

"I  do  not  know  whether  I  can  help  you  or  not,  but  I  am  going 
to  venture — not  as  official  chairman  but  as  a  teacher — to  sum  up 
briefly  my  impressions  of  the  last  few  days,  to  give  you  something 
to  differ  with,  and  to  help  perhaps  to  focus  our  attention  for  a  review. 

"I  seem  to  get  these  impressions  with  reference  to  the  'Place  of 
Health  Education  in  the  Curriculum': 

"1.  That  there  should  be  conscious  provision  by  school  officials   Summary. 
and  teachers  for  Health  Education  in  each  year  of  the  child's  life 
in  school — in  each  month — in  each  week — and  perhaps  in  each  day. 

"2.  That  Health  Education  should  permeate  the  life  of  the  child 
in  school,  at  home,  and  in  the  community,  in  its  practical  applications. 

"3.  That  the  provision  of  time,  and  place  of  Health  Education,  its 
specific  arrangement  and  adaptation  in  relation  to  other  subjects, 
or  as  given  by  itself,  will  depend  upon  the  school,  its  general  program 
and  policy,  and  must  be  worked  out  appropriately,  for  each  school 
system. 

"4.  That  the  training  of  the  teacher  for  this  profession  of  Health 
Education  is  of  paramount  importance. 

"5.  That  there  must  be  the  most  efficient  available  supervision, 
because  of  the  large  numbers  of  children,  and  the  several  or  consider- 
able number  of  people  involved  in  the  Health  Education  of  the  child. 
Because  of  the  danger  of  overlapping,  of  conflict,  of  duplication,  in- 
telligent supervision  alone  can  provide  the  coordination,  proper  grada- 
tion and  progression  of  the  material  in  Health  Education,  wherever 
its  place  in  the  curriculum." 

Mr.  Safford  brought  out  a  point  which  seemed  a  fitting 
conclusion  to  the  discussion — namely,  that  all  of  the  points 
of  view  presented  during  the  morning  were  most  important 
but  the  vital  one  could  be  expressed  by  the  thought  that  the 
process  of  education  takes  place  in  the  relationship  between 
the  pupil  and  the  teacher  and  all  other  things  are  contribu- 
tory to  that  wonderful  and  marvelous  end. 


Section  IV 

PROMOTION  OF  HEALTH  HABITS 

A.  Incentives  and  Motives 


B.  Successes  and  Failures 

HOW  most  efficiently  to  get  the  health  message  over  to 
the  child  is,  after  all,  the  crucial  point  in  any  Health 
Education  program.    Upon  analysis  of  the  problem, 
these  two  important  questions   arose   for   consideration. 
First,  what  incentives  and  motives  are  pedagogically  and 
psychologically  sound — in  short,  are  really  valid;  and  sec- 
ond, what  methods  and  devices  have  proved  successful,  and 
what  failures  ?    Why  has  this  been  so  ? 

From  the  evaluation  of  the  pooled  experiences  of  the 
Conference  on  this  point,  the  committee  felt  that  we  ought 
to  derive  a  sounder  basis  than  we  have  yet  had  for  a  pro- 
gram of  the  promotion  of  health  habits. 

Incentives  and  Motives 


To  present  the  subject  of  Incentives  and  Motives  that 
are  applicable  to  Kindergarten  and  Primary  School  children, 
the  committee  went  to  Miss  Julia  Abbot,  Specialist  in 
Kindergarten  Education  of  the  U.  S.  Bureau  of  Education, 
and  to  Professor  Patty  S.  Hill,  Director  of  Kindergarten  and 
Primary  Education,  Teachers*  College,  Columbia  University. 

Dr.  Wood,  therefore,  introduced  Professor  Patty  S.  Hill 
to  address  the  Conference  on 

Health  in  Early  Childhood 

Professor  Hill: 

IT  is  somewhat  dangerous  to  appear  on  the  program  late 
in  the  week,  especially  when  one's  audience  is  made  up 
of  experts  in  the  aspect  of  education  under  discussion.  I 
should  like  to  say  a  word  about  the  relation  of  those  of  us 
who  have  the  general  care  and  education  of  children  to 
experts.  We  need  as  never  before  expert  help  in  the 
guidance  and  direction  of  classroom  practice.  We  need 
our  findings,  and  theories,  and  convictions,  put  to  the  test 

(82) 


83 

of  proof  and  in  this  way  classroom  teachers  and  experts 
can  cooperate  for  the  welfare  of  the  young  child. 

My  topic,  as  you  know,  is  health  in  early  childhood.  The  When  to 
importance  of  the  establishment  of  habits  of  health  in  early  Health* 
childhood  goes  without  saying  in  such  an  intelligent  au-  Habits. 
dience  as  this.    The  great  problem  is  how  to  get  these  habits 
of  health  established  in  early  child  life.     Other  problems 
are, — when  shall  we  begin  the  inculcating  of  these  habits, — 
where  shall  it  be  done  and  by  whom?    When  it  comes  to  a 
study  of  the  best  age  we  are  beginning  to  realize  that  the 
sixth  year  is  too  late,  and  that  much  waste  exists  as  the 
result  of  the  tendency  of  the  school  to  set  this  as  the  chron- 
ological age  for  training  in  health  habits.   Even  the  Kinder- 
garten age  from  four  to  six  may  lose  time,  and  at  present 
many    interesting   experiments    are   being   made   in   this 
country  and  abroad  with  children  as  young  as  two  years. 

The  next  problem  is  one  as  to  the  best  place  and  the  best 
guides  in  this  movement.  This  work  must  be  done  not  only 
by  the  home  through  the  mother,  and  in  the  school  by  the 
classroom  teacher,  but  in  the  community  through  public 
clinics  and  maternity  centers.  In  other  words,  we  need  the 
full  cooperation  of  all  of  those  who  come  in  contact  with 
young  children  if  the  best  results  are  to  be  attained.  When 
we  get  the  mother,  the  school  doctor,  the  school  nurse,  the 
classroom  teacher,  the  family  physician,  and  the  child  him- 
self on  the  job,  the  work  will  be  done. 

Much  can  be  done  for  the  child  by  setting  him  in  a 
health  situation  or  environment.  For  example,  if  we  train 
the  mothers  of  young  children  in  the  importance  of  certain 
health  habits  which  naturally  arise  in  home  situations, 
much  can  be  done  there.  In  the  school  we  need  not  only 
the  supervision  of  the  medical  inspector  and  the  school  ^  Need  for 
nurse,  but  we  need  a  new  type  of  classroom  teacher  for  Teachers6 
children  under  the  eighth  year.  The  best  description  I  can  <™<d  . 
give  of  this  teacher  of  the  future  is  that  she  shall  be  trained 
not  only  as  an  instructor,  but  that  she  shall  give  something 
of  the  maternal  care  of  a  mother  in  addition  to  the  scien- 
tific care  of  a  trained  nurse;  but  no  environment  of  health 
will  suffice  unless  the  environment  is  used  intelligently  by 
the  mother,  the  teacher,  and  the  child.  We  need  a  new  type 
of  curriculum.  A  curriculum  that  lays  emphasis  on  activity 
of  body  as  well  as  activity  of  mind.  Schools  make  young 
children  prematurely  lazy  by  inhibiting  their  natural  ten- 


84 


A 

"Conduct' 
Curric- 
ulum. 


"Health 

Habits" 

Versus 

"Health 

Ideas." 


dency  to  physical  movement,  and  by  setting  a  premium  upon 
the  use  of  the  mind  at  the  cost  of  the  body. 

As  we  look  at  the  stages  of  childhood  we  realize  that  in 
infancy  everything  has  to  be  done  for  the  baby.  He  can 
do  nothing  for  himself  and  is  absolutely  at  the  mercy  of 
those  who  have  the  care  of  him.  Now  that  we  are  studying 
the  possibility  of  educating  children  at  the  second  year  we 
find  that  these  "toddlers"  or  "runabouts,"  as  they  are  called 
in  the  day  nurseries  and  nursery  schools,  can  be  trained  to 
do  much  for  themselves.  In  other  words,  we  can,  and  must, 
get  at  health  through  the  children.  It  is  the  self  that  must 
get  to  work,  as  no  amount  of  care  in  providing  a  health 
environment,  or  in  health  care  by  adults,  will  suffice  until 
we  secure  the  cooperation  of  the  child. 

In  order  to  form  these  health  habits  which  require  the 
cooperation  of  the  child,  we  have  to  gain  his  interest  and 
his  help,  as  it  cannot  come  by  coercion.  The  young  child 
has  little  or  no  native  interest  in  health,  and  yet  he  is  never 
so  susceptible  to  disease  at  any  later  stage  of  his  develop- 
ment. For  this  reason  we  are  mapping  out  what  we  call  a 
"Habit  or  Conduct  Curriculum,"  in  which  a  very  large 
proportion  of  the  habits  to  be  included  are  those  .which  have 
to  do  with  the  prevention  of  disease  and  the  promotion  of 
health  and  growth.  Anyone  who  has  worked  with  young 
children  knows  by  experience  that  you  can  arouse  a  child's 
interest  in  his  growth  in  height  and  his  increase  in  weight. 

To  me  the  most  important  problem  for  us  to  consider 
in  health  work  with  young  children  is  the  fact  that  health 
ideas  will  not  suffice.  It  is  health  habits  and  not  health 
knowledge  which  will  carry  the  issue  through  to  success. 
A  habit  is  a  thought  or  an  idea  put  into  action  and  repeated 
until  we  can  depend  upon  the  response  of  the  child  without 
the  help  of  teachers  or  parents.  In  other  words,  it  is  the 
actual  establishment  of  these  health  ideas  in  action. 
Whether  it  be  in  the  home  or  in  the  school,  whether  it  be 
done  by  the  parent  or  the  teacher,  this  is  the  goal  toward 
which  all  must  work.  My  personal  criticism  of  much  of  the 
health  work  done  in  the  schools  is  that  we  hope  through 
health  ideas  to  solve  the  problem.  In  addition  to  this  the 
work  is  handicapped  by  our  attempt  to  do  in  the  schools 
what  should  be  done  in  the  homes,  and  can  be  done  in  the 
homes  when  we  reach  the  parents.  Until  we  realize  that 
the  training  of  the  parent  is  just  as  much  a  part  of  the 


85 

education  of  the  child  as  the  work  done  with  the  child,  we 
cannot  reach  the  core  of  the  matter.  In  other  words,  those 
habits  of  health  which  must  be  carried  out  in  the  home 
must  be  placed  before  parents  in  their  true  light  and  im- 
portance. We  can  reach  them  only  indirectly  in  the  class- 
room and  when  this  indirect  method  is  used  we  have  no 
guarantee  that  they  will  carry  over  into  action  in  the  home. 
As  an  example  of  this  we  have  the  importance  of  long  hours 
of  sleep  and  of  fresh  air  in  the  sleeping  room.  These  are 
not  situations  which  arise  in  the  school,  and  the  most  that 
we  can  do  in  the  school  is  to  enlighten  the  child,  hoping  that 
he  will  carry  them  out  in  spite  of  the  difficulties  and  lack  of 
intelligence  on  the  part  of  his  parents.  On  the  other  hand, 
if  these  habits  are  explained  to  the  parents,  the  parents 
should  be  held  responsible  for  their  formation  in  the  home. 
Most  of  the  devices  used  in  health  work  are  due  to  the  fact 
that  we,  as  teachers,  are  trying  to  do  with  the  children 
what  we  should  do  with  the  parents  instead.  We  have  a 
direct  responsibility  to  the  parents  as  well  as  to  the  chil- 
dren. We  are  trying  the  experiment  in  the  Horace  Mann  Coopera- 
School  of  putting  our  habit  curriculum  in  the  hands  of  the  l^ween 
parents,  asking  the  parents  to  keep  a  record  of  the  chil-  Home  and 
dren's  progress  in  those  habits  peculiar  to  the  home,  and  SchooL 
those  of  importance  in  both  the  school  and  the  home.  In 
turn  we,  as  teachers,  report  to  the  parents  on  the  progress 
of  the  child  in  the  health  habits  which  should  be  formed  in 
the  school. 

Until  the  child  forms  certain  habits  of  health  he  has 
no  protection  when  separated  from  the  care  of  the  parent 
or  the  teacher.  Therefore,  he  must  be  taught  to  protect 
himself  and  to  protect  others  by  direct  and  definite  training 
in  the  conduct  of  health. 

It  is  highly  important  for  those  who  have  the  care  of  The  Rela- 
very  young  children  to   realize   that  we  have  emotional  ^motion  to 
habits  as  well  as  habits  of  mind  and  body.     We  are  just  Health. 
coming  to  realize  the  grave  importance  of  the  psychology 
of  the  emotions  in  relation  to  mental  and  bodily  health. 
Much  that  we  blame  on  heredity  and  trace  to  original  dis- 
position, can  easily  be  accounted  for  by  the  early  estab- 
lishment of  bad  emotional  habits  of  fear,  irritability,  rage, 
jealousy,  discouragement,  depression,  timidity,  melancholy, 
suspicion   and   discontent.     On   the   other   hand,    we  can 
definitely  set  for  ourselves  the  goal  of  forming  habits  of 


86 

happiness  and  enjoyment  and  enthusiasm  in  our  daily  life; 
of  courage,  of  amiability,  and  of  generosity  toward  others. 
Self-confidence  is  largely  a  matter  of  training  as  well  as 
heredity.  Belief,  not  only  in  one's  self,  but  in  one's  fellows, 
may  be  traced  back  to  habits  of  early  life.  Until  we  realize 
that  negative  emotional  habits  have  just  as  much  to  do  with 
ill  health  as  germs,  we  have  fallen  far  short  of  our  standard. 
We  know  today  as  we  never  knew  before,  that  happiness 
and  contentment  affect  the  flow  and  the  circulation  of  the 
blood,  respiration,  secretion  and  excretion,  and  that  as  the 
negative  emotions  affect  them  disastrously,  so  may  the 
positive  emotions  become  what  Dr.  Montessori  calls  "an 
inoculation  of  health."  I  will  list  a  few  of  the  health  habits 
taken  from  our  habit  curriculum: 

1.  Not  to  handle  one's  own  food  or  that  of  others. 

2.  To  keep  hands  and  materials  out  of  the  mouth. 

3.  To  keep  fingers  away  from  the  nose  and  the  ears. 

4.  Posture  in   sitting   and   in  walking. 

5.  The  right  use  of  the  toilet. 

6.  The  correct  use  of  the  individual  drinking  cup  at  luncheon. 

7.  The  correct  use  of  the  handkerchief. 

8.  The  washing  of  the  hands  before  eating  and  after  going  to 

the  toilet. 

9.  The  drinking  of  milk  and  water. 

We  hope  to  have  this  habit  curriculum  ready  for  cir- 
culation in  the  early  fall,  and  when  this  is  published  we 
wish  to  circulte  it  among  teachers  and  parents,  so  that  both 
the  home  and  the  school  can  work  together  in  saving  our 
children  in  the  future. 

My  final  word  is  that  our  children  are  to  be  saved  by 
the  intelligent  cooperation  of  all  with  whom  the  child 
comes  in  contact,  as  well  as  by  the  child  himself.  When 
we  all  realize  that  this  is  a  sacred  responsibility  we  will 
pull  together,  and  we  can  help,  not  only  to  prevent  disease, 
but  to  build  up  a  new  conception  of  the  importance  of  health 
in  the  minds  of  the  children,  the  parents,  the  teachers,  and 
the  community.  It  ought  to  be  just  as  important — even 
more  important — for  a  child  to  pass  an  examination  in 
progress  in  health  as  to  pass  in  reading  and  writing,  and 
the  school  must  have  the  same  sense  of  responsibility  here 
that  it  has  in  the  subjects  of  the  curriculum. 


87 


Discussion 

The  discussion  of  Professor  Hill's  paper  was  led  by  Miss 
Harriet  Wedgwood,  of  the  United  States  Bureau  of  Educa- 
tion. 

Miss  Wedgwood: 

"There  are  many  things  that  seem  to  me  to  be  very  important  in 
the  address  you  have  just  heard.  It  seems  to  me  that  we  must 
emphasize  in  the  training  of  teachers — first,  that  the  child  must  be 
studied  as  an  individual.  The  child  has  an  energy  of  his  own  and 
it  must  be  used  to  the  full  for  the  child's  own  happiness.  It  must 
be  used  in  ways  to  give  satisfaction  to  the  child,  if  you  are  going 
to  effect  the  complete  use  of  it.  Think  of  the  child  as  a  dynamo. 
If  you  can  connect  with  that  dynamo  you  have  the  energy  from 
the  child  himself  to  get  this  thing  over.  In  large  measure  you  have  to 
make  these  connections — these  are  what  you  might  call  the  'motives/ 
It  is  more  than  a  matter  of  devices.  Sometimes  you  make  what  seems 
to  be  a  legitimate  connection,  with  no  results.  Repressions  and  in- 
hibitions must  be  thought  of.  They  are  individual,  but  you  must 
take  account  of  them. 

"The  speaker  has  also  emphasized  the  fact  that  you  must  make   Implant 
use  of  situations  as  they  arise.     In  order  to   do  that  the  teacher   the 
must  have  a  large  reservoir  of  information  and  she  must  also  have    Ti^e?v>  • 
enthusiasm  for  teaching  health.    Moreover,  it  is  understood  that  most  Childhood. 
energies  of  many  adults  are  expended  to  fulfill  childhood  wishes — 
wishes  that  are  no  longer  really  practicable,  but  something  that  had 
always  been  wanted  and  must  be  got  for  the  satisfaction  of  that 
individual.    If  that  is  the  case,  the  wish  for  health  must  be  implanted 
in  the  child  at  a  very  early  age.    The  wish  for  health  must  also  be 
so  strongly  implanted  in  the  teacher  that  she  must  'ooze'  health. 

"A  physician  said  that  he  was  treating  a  patient  who  could  not  get 
well.  There  was  not  much  wrong  with  her,  as  far  as  he  could  see, 
but  she  would  not  recover.  He  said  to  her:  'I  wish  you  would  make 
out  a  balance  sheet  for  me — on  one  side  put  all  the  reasons  for 
being  well  and  on  the  other  side  all  the  advantages  of  being  sick, 
or  a  little  delicate.'  She  brought  it  back,  well  filled  out,  for  she 
was  quite  honest,  with  a  few  reasons  for  being  well  and  two  pages 
of  advantages  of  being  sick.  She  got  well. 

"The  pain-pleasure  motive  operates  in  all  of  us.  We  go  after  the 
thing  that  is  going  to  give  us  satisfaction,  and  some  of  us  have  for- 
gotten how  we  thought  and  felt  when  we  were  children.  We  think 
we  know  children  pretty  well — some  people  say  we  do  not  know 
whether  we  know  them  or  not.  Keeping  an  open  mind  is  what  I 
want  to  urge." 

Miss  White  made  this  comment  on  Professor  Hill's 
paper : 

"We  have  been  trying  out  in  Detroit  since  January  the  experiment 
of  which  Miss  Hill  speaks.  We  have  been  fortunate  enough  to  have 


88 


Health 
Education 
in  a 

Nursery 
School. 


"Nurse- 
Minded" 
Teachers 
for  Young 
Children. 


Miss  Grace  Owen's  assistant  from  England  to  help  us  with  our  work. 
We  believe  we  should  take  more  advantage  of  the  intelligence  of 
children.  We  have  children  from  20  months  to  two  years,  and  they 
are  very  intelligent.  Fortunately,  they  have  a  very  keen  sense  of 
individual  possession,  which  enables  us  to  get  across  the  idea  of  the 
individual  toothbrush,  towel,  blanket,  etc.  They  resent  interference 
from  anybody  else.  Even  at  this  early  age,  the  group  sets  standards, 
particularly  standards  for  behavior,  and  the  children  respond  to  this 
in  a  very  unusual  way.  In  our  work  with  the  mothers,  we  put 
emphasis  on  the  idea  that  the  child  at  this  early  age  does  form 
habits.  Parents  say  the  words,  but  they  do  not  quite  understand 
that  what  the  child  is  doing,  in  relation  to  his  behavior,  is  forming 
a  habit.  You  must  make  them  understand  that  the  formation  of  the 
right  habits,  even  at  an  early  age,  is  very  important.  They  fail 
to  recognize  the  importance  of  behavior  habits  upon  the  health  of 
children.  We  must  get  across  to  the  parents  this  fact,  if  the  mothers 
are  going  to  cooperate  with  us  in  forming  the  right  kind  of  health 
habits." 

Miss  Rood  said: 

"We  get  the  spirit  of  the  nurse  over  to  the  teacher,  and  the  health 
knowledge  of  the  nurse  over  to  the  mother.  Everyone  realizes  the 
necessity  of  the  mother's  cooperation.  But  first,  how  are  we  going 
to  get  this  spirit  of  the  nurse  over  to  that  teacher  and  the  knowledge 
of  health  over  to  the  mother?  And  second:  What  is  the  best  way 
of  preparing  the  people  who  prepare  the  teacher  to  get  this  knowledge 
over  to  the  mother?" 

Miss  Ethel  Perrin,  Assistant  Director,  Health  Educa- 
tion, Detroit  Public  Schools,  returning  to  the  Nursery 
Schools,  said: 

"A  very  important  thing  in  the  Merrill-Palmer  School  of  which 
Miss  White  spoke,  is  that  they  take  time  to  allow  the  children  to 
make  failures  and  mistakes  and  to  learn  from  those  the  proper 
habits.  My  experience  is  that  in  the  public  schools  our  teachers 
never  can  take  the  time  to  allow  the  children  to  make  mistakes.  In 
the  Merrill-Palmer  School,  I  have  seen  a  child  allowed  to  take  a 
pitcher  much  too  full  and  pour  the  water  on  the  table  and  floor.  The 
teacher  said  nothing — the  child  did  not  know  that  she  was  noticing  it — 
but  went  to  work  and  cleaned  the  mess,  and  things  went  on  as  usual. 
They  take  time  for  the  children  to  learn  from  their  own  experiences — 
this  time  is  not  allowed  in  the  public  schools." 

Professor  Hill  added : 

"We  must  get  the  nurse  habit  over  to  the  teacher.  The  latter 
should  have  a  good  big  part  of  the  course  taken  by  doctors  and 
nurses.  At  Columbia  we  have  teachers  now  teaching  children  in 
the  Kindergarten,  pre-Kindergarten  group  and  first  grade  work. 
They  have  their  regular  work  with  Dr.  Wood  in  'School  and  Personal 
Hygiene';  they  also  work  with  Dr.  Kenyon,  the  baby  doctor,  and 
with  the  nurses;  and  the  next  year  in  the  baby  clinics.  It  is  a  well- 


89 

known  fact  that  with  this  pre-Kindergarten  work  in  England  (which 
they  call  the  Nursery  School),  they  have  their  teachers  do  a  part 
of  their  work  in  the  Baby  Hospital.  There  may  be  some  waste  of 
time  there.  I  believe  we  should  bring  up  a  body  of  teachers  who  are 
nurse-minded.  They  must  have  all  that  knowledge  of  the  trained 
nurse  which  functions  in  the  schools;  a  mother-teacher-nurse  person 
must  have  the  care  of  the  child  up  to  eight  years." 

Dr.  Barrows  then  called  attention  to  the  fact  recently 
noted  in  letters  from  London,  appearing  in  the  Journal 
of  the  American  Medical  Association,  the  statement  that 
during  the  past  year,  out  of  the  thousands  of  children  who 
were  examined  by  medical  inspectors  with  the  help  of 
nurses  in  the  schools  in  England,  80  per  cent,  were  ex- 
amined in  the  presence  of  one  or  both  of  their  parents.  He 
said  that  when  the  time  came  that  we  could  get  eight 
mothers  out  of  ten  of  the  children  in  our  schools  to  be  pres- 
ent during  the  examination  of  the  children  and  to  talk  to 
the  doctors,  even  though  they  may  ask  questions  that  are 
irrelevant — when  we  got  to  that  point  there  would  not  be 
so  many  problems  in  connection  with  school  health. 

The  Chairman  then  introduced  Miss  Julia  Wade  Abbot, 
Specialist  in  Kindergarten  Education,  Bureau  of  Educa- 
tion, Washington,  D.  C. 

Interests  of  Young  Children  as  the  Basis  for  Health 
Teaching  in  the  Kindergarten 

Miss  Abbot: 

WE  can  formulate  methods,  W£  can  standardize  subject 
matter,  but,  thank  God,  we  cannot  standardize  chil- 
dren! Last  summer  I  heard  Frederic  Burk  give  a  new 
definition  of  the  Project  Method.  He  said  it  was  using  the 
child's  own  "hunch."  That  is  what  all  the  previous  speak- 
ers have  been  doing,  and  I,  too,  shall  use  that  method  and 
talk  quite  freely  from  my  experience  with  young  children. 
We  cannot  think  of  "Incentives"  and  "Motives"  without 
thinking  of  children. 

But  before  we  come  to  the  children  I  want  to  say  a 
word  about  the  Normal  School  student.  Courses  given  in 
Normal  Schools  have  often  been  of  two  extremes.  The 
content  courses  have  been  made  up  of  technical,  academic 
material  which  the  student  masters  by  "cramming."  The 


90 


Learning 
to  Use 
"tfo  Most 
Delicate 
Instrument 
in  the 
World." 


so-called  ' 'method"  courses  have  consisted  too  largely  of 
devices  to  be  practiced  on  innocent  children.  These  courses 
do  not  help  the  student  to  understand  children,  to  know 
how  children  think  and  feel.  The  result  is  that  when 
she  becomes  a  teacher  she  either  uses  devices  or  she  falls 
back  upon  the  methods  that  were  practiced  upon  her  when 
she  was  a  child.  She  may  even  employ  the  very  bad  meth- 
ods used  by  her  professors  in  the  Normal  School  in  giving 
her  subject  matter!  All  courses  in  the  Normal  School 
should  embody  the  same  principles  and  practice  that  the 
student  is  expected  to  use  when  she  goes  out  to  teach. 

There  would  be  need  of  fewer  method  courses  if  the 
Normal  School  girl  could  learn  to  know  children  during  the 
period  of  her  training.  She  comes  to  the  Normal  School 
or  Teachers'  College  as  a  High  School  girl,  not  as  a  teacher. 
She  must  make  the  transition  from  getting  direct  results 
through  her  own  cleverness,  recorded  in  marks  or  in  the 
acclaim  of  her  classmates,  to  working  through  others.  She 
must  learn  to  use  the  most  delicate  instrument  in  the  world 
— the  personality  of  a  child.  She  must  learn  to  respect  that 
personality.  Caldwell  Cook,  in  "The  Play  Way,"  expresses 
this  idea  very  beautifully.  "Once  you  realize  that  the 
teacher  only  exists  for  the  learner,  once  you  believe  that 
the  soul  of  any  other  being  entrusted  to  your  care  is  greater 
than  the  furniture  of  your  own  mind,  once  this  belief  in 
you  reaches  the  level  of  a  faith,  then,  believe  me,  the  moun- 
tain of  your  learning  and  self-sufficiency  is  easily  removed 
and  brought  to  the  feet  of  the  prophet."  Courses  in  School 
Management  and  Introduction  to  Teaching  and  History  of 
Education  will  never  give  the  student  this  attitude.  She 
must  become  really  interested  in  children,  interested  in 
their  funny  little  ways,  in  their  clumsy  endeavors,  in  their 
whimsies  that  thwart  one's  own  purposes. 

How  is  this  teacher-attitude  to  be  established  ?  By  build- 
ing on  the  interests  of  the  High  School  girl  so  that  she  may 
get  the  child's  own  point  of  view.  Teachers  can  only  under- 
stand children  by  keeping  young  themselves.  The  student's 
joy  in  play  and  recreation  should  be  abundantly  satisfied. 
She  should  be  encouraged  to  recall  memories  of  her  own 
childhood,  telling  the  games  she  played  and  playing  them 
again  in  game  class,  recalling  the  lessons  she  liked  and  those 
she  hated — and  why.  She  will  be  interested  in  going  back 
to  her  earliest  memories  and  trying  to  find  out  why  those 


91 

particular  happenings  have  remained  in  memory.  In  such 
natural  ways  she  will  get  the  child's  point  of  view. 

And  then  there  is  the  appeal  to  the  imagination  through 
literature.  Such  studies  of  children  as  Ewald's  "My  Little 
Boy,"  "Emmy  Lou"  and  "Penrod"  have  their  place  in  her 
training.  But  best  of  all  is  the  actual  experience  of  moth- 
ering some  young  children.  Fortunate  is  the  girl  who  had 
such  an  experience  as  early  in  her  school  course  as  Gram- 
mar School.  Taking  care  of  children  on  excursions,  caring 
for  them  in  day  nurseries,  makes  the  prospect  of  teaching 
a  human  thing  instead  of  a  military  calling ! 

And  now  we  come  to  the  problem  of  teaching  health 
habits  to  the  youngest  children  in  the  schools.  In  its  first 
stages,  Health  Education  should  be  largely  a  matter  of 
unconscious  response  to  the  right  kind  of  environment. 
The  teacher  will  make  practical  application  of  the  technical 
courses  she  has  had  in  Normal  School  in  providing  the  right 
physical  conditions  for  the  children  in  her  care.  We  don't 
realize  what  a  tremendously  strong  ideal  we  must  build  up 
in  the  student's  mind  for  being  responsible  for  the  health 
conditions  in  her  school.  The  average  teacher  is  so  over- 
burdened with  numbers  of  children  that  it  is  natural  for 
her  to  avoid  movement  and  change  in  her  school  program. 
In  cold  weather  there  are  so  many  wraps  to  put  on  and 
take  off.  It  takes  a  firmly  implanted  ideal  of  health  to  take 
forty  or  more  little  children  out  of  doors  for  a  part  of  the 
morning.  And  in  the  game  period  it  is  much  simpler  to 
have  the  large  group  of  children  sitting  or  standing  still 
while  the  few  perform  in  an  orderly  way.  The  teacher 
must  be  so  enthusiastic  about  health,  and  so  intelligent 
about  ways  of  providing  for  healthful  living  in  the  school- 
room, that  in  health  the  children '"live  and  move  and  have 
their  being." 

The  teacher  must  remember  that  she  must  share  with 
the  mother  the  responsibility  for  the  health  of  the  younger 
children.  Her  Normal  School  course  should  prepare  her 
for  helping  the  mothers  of  the  children  to  get  a  new  view- 
point on  the  subject  of  health.  She  should  be  prepared 
to  work  with  the  mothers  through  home  visiting  and 
Mothers'  Meetings. 

But  while  mothers  and  teachers  should  be  mainly  re- 
sponsible for  the  health  habits  of  the  younger  children, 
children  of  4  and  5  and  6  may  learn  some  very  definite 


92 


Health 
Teaching 
Oppor- 
tunities in 
Natural 
Situations. 


What 
are  the 
Proper 

Incentives? 


things  about  health.  Real  situations  are  the  best  means 
for  teaching  children  of  this  age.  There  has  been  a  ten- 
dency to  introduce  fantastic  and  artificial  methods  into  the 
early  grades  to  "get  over"  the  idea  of  health.  If  children 
are  living  happily  and  naturally  together  in  the  right  kind 
of  school  regime,  plenty  of  opportunities  will  arise  for 
teaching  health  without  the  introduction  of  artificial  de- 
vices. 

McDougall  gives  four  levels  of  behavior — first,  the  in- 
stinctive, modified  by  pains  and  pleasures  incidentally  ex- 
perienced; second,  the  level  modified  by  rewards  and  pun- 
ishments in  the  social  environment;  third,  the  level  modified 
by  anticipation  of  social  blame  or  praise;  and,  fourth,  the 
level  of  the  highest  kind  of  conduct — doing  what  is  right 
regardless  of  praise  or  blame.  It  is  a  question  whether  we 
have  not  kept  children  on  the  second  level  in  schoolroom 
practice,  when  we  might  have  lifted  them  to  the  third  level 
by  using  the  natural  incentives  furnished  by  the  life  of  the 
social  group.  In  one  Kindergarten  that  I  visited  I  saw  the 
names  of  the  children  on  a  chart  hung  up  on  the  wall.  Some 
of  the  names  were  glorified  by  stars,  other  names  were  plain 
and  bare.  I  was  told  the  non-starred  ones  were  the  under- 
weight children.  "Surely,"  I  said,  "that  is  a  chart  for  the 
mothers  of  these  little  children !"  "Oh,  no,"  said  the  teacher, 
"that  is  for  the  children,  they  are  so  interested!"  I  won- 
dered what  kind  of  interest  was  manifested  by  the  "non- 
stars."  I  thought  of  the  neglect  of  early  years,  the  poverty 
and  ignorance  that  perhaps  was  back  of  that  chart,  and 
babies  were  being  held  responsible !  And  while  the  reward 
in  the  form  of  a  star  by  one's  name  may  seem  small  to  us, 
we  must  remember  the  pathetic  eagerness  of  children  to 
receive  crowns  of  glory  even  in  the  form  of  gilt  paper  stars ! 

In  another  Kindergarten  the  children  were  eating  their 
luncheon  of  milk  and  crackers.  It  was  a  rainy  day  and 
there  was  some  extra  milk  in  the  big  pitcher.  The  teacher 
was  talking  to  a  visitor  and  Rosie  came  over  and  said,  "Say, 
Miss  Andrews,  there's  more  milk."  "Give  it  to  the  children 
who  need  it,"  she  was  told.  In  a  few  minutes  Rosie  came 
back  and  reported,  "It's  all  gone,  I  give  it  to  the  skinny 
ones !"  And  there  you  have  the  contrast  in  the  methods  in 
these  two  Kindergartens — artificial  rewards — natural  situ- 
ations. Besides  using  artificial  rewards  with  children,  they 
are  often  given  information  and  facts  about  things  instead 


93 

of  learning  directly  from  experience.  In  one  Kindergarten 
the  children  were  being  gently  inducted  into  the  germ 
theory  by  being  told  all  about  the  little  "sick-seeds"  that  are 
scattered  everywhere  when  one  sneezes!  There  are  plenty 
of  real  situations,  such  as  blowing  the  horn  that  Joe  has 
brought  to  school  and  just  performed  upon,  or  the  using 
of  soap  bubble  pipes  and  drinking  cups.  When  Tony  spits 
on  the  floor,  much  more  effective  than  a  lecture  on  germs 
is  the  ceremonial  of  Tony's  getting  a  pail  of  water  and 
scrubbing  the  floor  under  the  disapproving  eyes  of 
"Teacher"  and  his  "pals" ! 

We  must  beware  of  a  negative  emphasis  in  health  teach-  Beware  of 
ing.  Bobbie's  mother  told  me  this  story.  He  surprised  her  Emphasis. 
one  morning  by  asking  for  some  coffee  in  his  glass  of  milk. 
"Just  one  or  two  little  drops,  mother,"  he  begged.  She  re- 
plied in  amazement,  "Why,  Bobbie,  you  never  have  had 
coffee  nor  wanted  it  before,  what  are  you  thinking  of?" 
"Well,  mother,"  he  said,  "I  want  to  tell  my  teacher  that 
I've  had  coffee  for  breakfast,  and  see  her  face  when  I  tell 
her!"  Which  reminds  me  of  another  story  of  a  teacher 
who  went  back  to  her  class  after  a  few  days  of  illness.  She 
had  heard  rumors  that  the  substitute  had  had  a  hard  time, 
and  she  asked  the  children  why  they  had  behaved  so  while 
she  was  gone.  They  were  very  frank  about  it.  "Well,  we 
didn't  like  her,  and  I  said  to  the  other  kids,  'Let's  be  bad/ 
and  we  was  bad."  "But  why  didn't  you  like  her?"  "Aw — 
she  shocks  so  easy!" 

We  must  not  forget  the  mental  health  aspect  of  teach- 
ing. Normal,  well-balanced  teachers  who  understand  chil- 
dren establish  a  social  order  in  their  schoolrooms  to  which 
the  children  unconsciously  respond.  Through  this  social 
order  they  learn  leadership  and  conformity,  self-expression 
and  self-control.  This  life  in  the  school  community  is  really 
the  beginning  of  civics.  A  child's  natural  attitude  is  that 
of  "a  little  friend  to  all  the  world,"  but  the  natural  emotions 
of  children  have  often  been  so  cruelly  thwarted  before 
they  reach  the  Kindergarten  that  it  is  very  necessary  for 
the  school  to  restore  the  child's  mental  health.  I  recall  an 
incident  of  the  charming  frankness  of  a  little  five-year-old 
Kindergarten  child  in  Washington.  The  children  of  the 
Tunior  Red  Cross  were  to  send  a  large  bunch  of  red  roses  to 
Queen  Elizabeth  of  Belgium.  A  little  girl  from  one  of  the 
Kindergartens  was  chosen  to  make  the  presentation.  Her 


94 

Kindergarten  teacher  said  to  her,  "Louise,  a  real  queen  is 
coming  to  Washington — she  is  Queen  of  Belgium,  and  the 
children  of  the  Junior  Red  Cross  are  going  to  send  her 
some  roses  and  they  want  you  to  give  them  to  her.  What 
shall  you  say  to  her?  Let's  play  that  I'm  the  queen."  So 
they  dramatized  what  was  really  going  to  happen.  When 
the  day  came  and  Queen  Elizabeth  held  her  audience,  Louise 
ran  fearlessly  to  her  and  said  in  her  clear,  child-voice,  "I 
brought  you  these  pretty  flowers,  Queen  of  the  Belgiums, 
they  are  from  the  Junior  Red  Cross."  The  queen's  eyes 
filled  with  tears.  "Remarkable,"  she  murmured.  And  then 
she  asked  the  child's  age,  and  then  she  said,  "May  I  kiss 
her?"  And  Louise  held  up  her  little  round  face,  and  re- 
ceived the  salute  of  a  queen ! 

Learning  Children  in  the  Kindergarten  learn  through  doing  things, 

"Doing."  and  they  learn  health  lessons  by  the  same  methods.  They 
go  on  excursions  and  make  the  acquaintance  of  the  police- 
man, fireman,  the  farmer  and  the  motorman.  The  janitor 
is  their  friend  and  a  much  more  important  person  than  the 
principal  of  the  school.  The  children  admire  strength  and 
dexterity,  and  through  their  admiration  form  health  ideals. 
By  means  of  excursions  and  gardening  they  become  ac- 
quainted with  fruits  and  vegetables  and  learn  which  are 
best  to  plant  and  to  eat.  They  learn  about  food  and  water 
and  cleanliness  through  the  care  of  pets.  Curiosity  is  a 
child's  key  to  knowledge.  Science  teaching  begins  in  in- 
vestigation and  in  asking  questions.  Even  children  of 
Kindergarten  age  need  facts  as  well  as  fancies,  and  children 
do  not  want  their  science  in  sugar-coated  pills.  Someone 
has  said  that  murder  is  committed  every  day  in  our  Ele- 
mentary Schools,  the  murder  of  curiosity.  Curiosity  is 
killed  by  the  use  of  silly  devices  or  by  mechanical  instruc- 
tion that  has  no  relation  to  the  life  and  interests  of  children. 
In  the  conversation  periods  of  the  Kindergarten  and  on 
excursions,  the  children  ask  many  questions.  "Is  clay 
cooked?"  "Does  oak-meal  grow  on  oak  trees?"  "Rubbers 
are  made  out  of  elephant's  skin,  aren't  they?"  And  some 
of  these  questions  will  relate  directly  to  matters  of  health, 
and  should  be  answered  in  a  commonsense  way. 

I  have  not  the  time  to  speak  of  the  emphasis  upon  health 
that  comes  so  naturally  through  the  care  of  the  doll  and 
through  play  with  doll  families,  and  in  the  projects  that  are 
worked  out  in  family  and  community  life.  To  give  just 


95 

one  illustration:  The  Kindergarten  children  were  making 
a  grocery  store.  They  had  been  to  visit  one  in  the  neigh- 
borhood and  had  noticed  that  all  the  loaves  of  bread  were 
wrapped  in  wax-paper.  The  teacher  told  them  why  this 
was  done.  When  their  own  little  loaves  were  made  of 
clay,  with  no  suggestion  from  the  teacher,  every  one  was 
carefully  wrapped  and  sold  under  sanitary  conditions ! 

Stories  and  rhymes  have  an  important  place  in  the 
Kindergarten.    As  the  social  order  of  the  Kindergarten  is 
the  means  for  establishing  habits,  through  stories  and 
rhymes  the  appeal  is  made  to  the  imagination,  and  we  build 
up  attitudes.    In  the  introduction  of  health  teaching  into 
the  school,  stories  and  rhymes  have  been  used  very  exten-  Respecting 
sively.    Even  familiar  rhymes  like  Mother  Goose  have  been  f^feach 
distorted  to  teach  health  truths.    It  may  be  interesting  to  Health. 
the  authors  of  these  modern  perversions  of  our  good  old 
friend  to  know  that  this  idea  is  not  original  with  them. 
As  long  ago  as  1879  a  little  volume  was  published  entitled 
Mother  Truth's  Melodies.    The  change  of  title  is  explained 
in  the  opening  rhyme : 

"Since  little  ones,  are  geese  no  more, 
But  knowing  have  become, 
It  ill  beseems  that  'Mother  Goose' 
Should  dwell  in  every  home. 
So  'Mother  Truth'  in  'Melodies' 
For  babes,  here  lifts  her  voice. 
Assured  that  parents,  children,  all, 
Will  welcome  and  rejoice." 

I  will  give  you  one  or  two  samples  of  these  gems  of 
truth: 

"Humpty-dumpty,  hip-o'-to-hop, 
Baby  was  crying,  but  now  he  will  stop;. 
What  did  he  cry  for?  his  clothing  was  wet; — 
No  wonder  such  things  should  make  babies  fret." 

Here  is  another : 

"Papa,  when  you  dive  me  tandy, 
Dive  me  only  white, — 
'Tause  there's  poison  in  the  tolored, 
Which  my  health  will  blight; 
Thint  how  tiders  drowl  and  drumble, 
And  then  dive  me  food  to  eat 
That  will   mate  me  well   and   happy, 
Wheat  and  oat-meal,  rice  and  fruit, 
These  will  mate  me  dood  and  gentle, 
'Stead  of  mating  me  a  brute." 


96 

In  the  modern  versions,  I  feel  as  insulted  when  the  dear 
familiar  "Sing  a  Song  of  Sixpence"  changes  into  "Sing  a 
Song  of  Tooth-paste"  as  I  would  if  some  one  remodeled 
Hamlet's  famous  soliloquy  into  "To  be  or  not  to  be  clean, 
that  is  the  question !"  Of  course,  it  is  quite  a  different 
thing  to  have  children  make  up  their  own  funny  little 
health  rhymes.  I  have  seen  some  delightful  ones  inspired 
by  the  "Child  Health  Alphabet."  And  there  are  children's 
rhymes  which  in  their  original  form  suggest  ideals  of 
health,  such  as  lullabies  and  "Wee  Willie  Winkie"  and 
Stevenson's  "Friendly  Cow."  But  health  is  a  byproduct  in 
these  verses.  Literature  is  for  the  joy  it  gives,  not  for 
instruction.  Literary  values  should  be  preserved  for  the 
younger  children  as  jealously  as  for  the  college  student. 
And  the  use  of  pure  literature  does  teach  health  in  the 
very  best  way  by  establishing  right  mental  habits.  In  the 
story  group  there  is  repose,  the  joy  of  contemplation,  the 
feeling  of  the  solidarity  of  the  group  that  grown  people 
feel  in  the  theatre  and  church. 

Besides  the  artificiality  of  changing  rhymes  to  teach 

something,  in  the  Health  Education  movement  there  has 

been  a  tendency  to  introduce  the  child  to  familiar  objects 

in  his  own  world  under  fanciful  names.     Nettie  Nailfile 

and  Henrietta  Handkerchief  are  the  creation  of  the  clumsy 

imagination  of  a  grown  person.    We  forget  that  a  child's 

whole  life  is  dramatic,  he  is  the  hero  of  his  own  Odyssey. 

Valid          He  is  interested  in  everything  that  affects  himself.     A 

lothe1  *       book  of  stories  has  appeared  recently  that  is  literature  and 

Imagina-     that  is  full  of  stories  of  things  which  touch  a  little  child's 

tion  of 

Childhood,    daily  experience.    I  refer  to  the  "Here  and  Now  Stories"  of 

Lucy  Sprague  Mitchell.  I  will  quote  from  but  one  story 
that  could  be  used  effectively  with  the  younger  children  in 
relation  to  the  health  habit  of  taking  a  bath.  The  name 
of  the  story  is  "How  the  Singing  Water  Got  to  the  Tub," 
and  I  want  to  quote  just  bits  of  it: 

"I  bubble  up  so  cool 
Into  the  pebbly  pool. 
Over  the  edge  I  spill 
And  gallop  down  the  hill!" 


97 

"What  shall  I  do,  oh,  what  shall  I  do? 
Here's  a  big  dam  and  I  can't  get  through, 
Behind  the  dam  I  fill  and  fill 
But  I  want  to  go  running  and  running  down! 
If  the  pipe  at  the  bottom  will  let  me  through 
I'll  run  through  the  pipe!     That's  what  I'll  do!" 

"Way  under  the  street,  street,  street, 
I  feel  the  feet,  feet,  feet, 
I  feel  their  beat,  beat,  beat, 
Above  on  the  street,  street,  street." 
*     *     *     * 

"'My!  but  I  need  a  bath  tonight,'  said  the  dirty  little  boy  as  he 
heard  the  water  splashing  in  the  tub.  The  water  was  still  the  singing 
water  that  had  sung  all  the  way  from  the  far-away  hills.  It  had 
sung  a  bubbling  song  when  it  gurgled  up  as  a  spring;  it  had  sung 
a  tinkling  song  as  it  rippled  down  hill  as  a  brook;  it  had  crooned 
a  flowing  song  when  it  bore  the  talking  boats;  it  had  muttered 
and  throbbed  and  sung  to  itself  as  it  ran  through  the  big,  big  pipe. 
Now  as  it  splashed  into  the  dirty  little  boy's  tub  it  laughed  and  sang 
this  last  song: 

"I  run  from  the  hill, — down,  down,  down, 
Under  the  streets  of  the  town,  town,  town, 
Then  in  the  pipe,  up,  up,  up, 
I  tumble  right  into  your  tub,  tub,  tub. 

And  the  dirty  little  boy  laughed  and  jumped  into  the  singing  water." 

In  contrast,  I  want  to  quote  from  another  type  of  story : 

"One  germ  said,  'I  have  tried  to  live  in  their  mouths,  but  every 
time  I  get  in  they  brush  me  out.'  Another  had  tried  to  live  on  their 
bodies  but  was  scrubbed  off  every  time.  A  wise  old  germ  said  that 
the  flies  would  carry  them  all  away  to  some  new  place  to  live. 

"The  little  people  of  Happy  Town  had  seen  the  flies  and  soon 
they  all  came  marching  down  the  street  to  Mrs.  Easy-mother's 
house  and  they  were  all  singing  Onward  Children  Soldiers.  They 
were  soldiers,  too.  None  of  them  carried  guns  but  each  one  of  them 
had  a  fly  swatter  on  his  shoulder  and  they  went  right  at  the  flies. 
This  was  a  great  surprise  to  all  the  flies.  Swatters  to  right  of  them, 
swatters  to  left  of  them,  swatters  in  front  of  them,  swatted  six 
hundred." 

We  are  so  ignorant  of  the  kind  of  images  we  create  in 
children's  minds.  I  was  telling  a  story  called  "The  Crane's 
Express"  to  a  group  of  Kindergarten  children.  The  climax 
of  the  story  was  given  in  these  words,  "And  so  the  little 
birds  were  carried  across  the  blue,  blue  sea  to  the  land 
where  it's  always  warm  and  where  if  a  little  bird  just 
opens  his  mouth  a  worm  walks  in  for  his  breakfast !"  The 
children  were  very  solemn  when  the  story  ended,  and  one 


98 


Play 

Instinct 

Used  to 

Motivate 

Health 

Education. 


little  girl  fixed  her  round  eyes  on  me  and  said  in  a  very 
literal  voice,  "I  had  to  take  medicine  for  worms  once !" 

Let  us  not  be  too  anxious  to  make  up  new  stories  until 
we  know  more  about  the  imagination  of  children.  The  old 
favorites  are  the  best,  after  all. 

I  have  attempted  to  show  that  students  should  be  led 
to  see  how  habits  may  be  built  up  through  the  social  order 
of  the  Kindergarten,  how  knowledge  may  be  acquired  in 
real  life  situations,  and  how  attitudes  may  be  created 
through  the  right  appeal  to  the  imagination. 

Above  all,  we  must  help  our  students  to  realize  that  the 
open  sesame  into  the  child's  world  is  to  become  as  little 
children.  The  spirit  of  that  child  world  has  been  sung  by 
Stevenson  in  "A  Child's  Garden  of  Verses" : 

"The  world  is  so  full  of  a  number  of  things, 
I'm  sure  we  should  all  be  as  happy  as  kings." 

Discussion 


The  discussion  on  Miss  Abbot's  paper  was  led  by  Miss 
Jennie  Haver,  County  Helping  Teacher,  Hunterdon  County 
Department  of  Public  Instruction,  Flemington,  N.  J. 

Miss  Haver: 

"  'Do  you  regard  your  work  as  an  affliction?'  is  a  very  pertinent 
question  asked  in  the  July,  1922,  number  of  the  American  Magazine. 
Whether  the  children  in  our  schools  regard  health  work  as  an  affliction 
or  as  a  fascinating  game  depends  in  large  measure  on  the  use  of 
incentives  and  motives  that  appeal  to  their  interest.  Miss  Abbot  has 
just  given  in  her  very  valuable  paper  many  specific  illustrations 
showing  how  the  interests  of  High  School  girls  are  used  as  a  basis 
for  their  work  in  the  Kindergarten  course  of  the  Normal  School 
and  then  shows  how  those  girls,  when  they  become  teachers,  may 
apply  the  same  methods  to  their  Kindergarten  pupils. 

"I  heartily  agree  with  Miss  Abbot  in  believing  that  play  may  be 
one  of  the  strong  native  forces  used  to  motivate  Health  Education 
not  only  in  the  Kindergarten  but  throughout  the  grades. 

"Joseph  Lee  in  his  epoch-making  book,  'Play  in  Education,'  gives 
seven  instincts  of  play,  namely,  creation,  rhythm,  hunting,  fighting, 
nurture,  curiosity  and  team  play.  Today  I  wish  to  discuss  how  some 
of  these  instincts  may  be  used  to  motivate  Health  Education  in  the 
grades. 

"From  the  day  the  child  makes  his  first  mud  pie  his  interest 
in  creating  things  never  wanes.  The  wise  teacher  uses  this  interest 
to  motivate  the  health  work.  Fruit  and  vegetables  and  utensils 
used  to  promote  healthy  living  are  modeled  from  clay,  health  stories 
are  illustrated  by  original  drawings  and  clever  cartoons  are  used 


99 

to  clinch  an  important  truth,  clever  posters  like  those  beautiful  ones 
shown  in  the  exhibit  room  on  the  first  floor  are  the  rule  now  rather 
than  the  exception.  Boys  and  girls  interested  in  photography  are 
using  that  medium  of  expression  to  further  their  interest  in  health. 
The  technique  of  paper  cutting  is  becoming  a  fine  art  and  booklets 
and  charts  are  being  made  in  hundreds  of  schools.  Original  health 
stories  are  written  and  in  many  cases  dramatized,  scenarios  for  health 
moving  pictures  are  written  and  pageants  are  developed  and  produced. 
The  passion  for  creating  properly  guided  adds  color  and  interest 
and  concreteness  to  many  health  projects. 

"The  fighting  instinct  (used  in  unsocial  ways  to  create  untold 
misery)  can  be  used  to  advantage  in  'Swat  the  Fly'  campaigns,  the 
conquest  of  consumption,  the  mosquito  campaign,  and  rat  extermina- 
tion. These  are  war  problems  to  engage  the  interest  of  any  fight- 
loving  boy  or  girl. 

"Competition   may,   if   intelligently   used,   become   a   stimulus   in  PT°S  and 
Health  Education.     It  is  the  common  element  in  all  of  our  games;   Campeti- 
to  leave  it  out  of  the  game  of  health  would  be  to  make  it  flat  indeed,   tion. 
Personally,  I  believe  that  the  major  use  of  school  competition  should 
be  between  groups  of  children  rather  than  between  individuals.   Many 
of  our  school  children  are  laboring  under  serious  handicaps  which 
give  them  an  unfair  disadvantage.     I  do  believe  in  individuals  com- 
peting with  themselves  and  trying  to  surpass  their  own  records. 

"Competition  brings  up  the  question  of  rewards  and  punishments. 
Miss  Abbot  is  just  in  her  criticism  of  the  abuse  of  rewards  and 
wnishments,  but  sometimes  we  err  on  the  other  side;  we  fail  to 
mnish  when  punishment  is  needed  and  withhold  the  legitimate  reward 
/hich  has  been  earned.  McDougall's  fourth  level  of  conduct,  doing 
rtiat  is  right  regardless  of  praise  or  blame,  is  a  splendid  ideal.  All 

us  are  striving  for  it,  but  few  have  reached  the  goal.     We  must 
)t  expect  too  much   from   young   children  who   have  not   reached 
lat  level.     A  button,  a  ribbon,  a  medal  will  leaven  a  big  amount 
)f  uninteresting  health  material.     A  banner  or  a  loving  cup  may 
jvolutionize  a  school. 

"The  nurturing  instinct  shown  by  the  Kindergarten  teacher  in 
ler  love  for  young  children,  and  by  the  tiny  tot's  care  of  her  dolls 

used  as  a  motive  force  in  much  of  our  modern  health  work.  The 
care  of  dolls,  the  care  of  pets,  the  care  of  other  children  are  all 
significant  features  of  it.  The  responsibility  and  protection  that 
older  children  may  show  for  younger  ones  is  brought  out  clearly  in 
Safety  First  work. 

"Last  Saturday,  the  State  Commissioner  of  Education,  the  Motor 
Vehicle  Commissioner,  the  Director  of  the  Department  of  Public 
Safety,  the  city  Mayor  and  a  long  list  of  visiting  dignitaries  met  in 
the  City  of  Newark,  New  Jersey,  to  do  honor  to  the  School  Safety- 
Patrol  winners  who  had  done  so  much  during  the  school  year  to 
lower  the  death  and  accident  rate  among  the  school  children  of 
Newark. 

"Team  play,  the  last  instinct  mentioned  in  Joseph  Lee's  list,  is  ^C^°g 
far  from  being  the  least  in  its  effective  motive  power.     It  appears   "Health 
later  than  many  of  the  others  but  what  it  loses  in  time  it  gains  in   Game." 


100 

intensity.  General  Sherman  said  that  there  is  a  soul  in  an  army 
as  well  as  in  a  man.  The  same  might  be  said  of  the  team.  The 
team  instinct  forms  the  basis  for  the  Health  Clubs  which  are  playing 
such  an  important  part  in  moulding  the  health  habits  of  thousands 
of  boys  and  girls. 

"This  morning  I  have  mentioned  briefly  just  a  few  of  the  play 
instincts  which  may  be  utilized  as  a  basis  for  the  motivation  of 
school  health  work. 

"If  we  expect  to  make  the  game  of  health  a  success  we  must 
base  our  work  on  sound  psychological  principles  and  then  go  at  it 
with  a  vim.  We  must  use  Tom  Sawyer's  method  when  he  had  to 
whitewash  the  fence.  You  remember  that  he  put  such  artistic 
appreciation  into  his  job,  that  the  other  boys  instead  of  pitying  him 
actually  parted  with  their  most  treasured  possessions  for  the  glorious 
privilege  of  doing  his  work  for  him." 

Miss  Jean: 

"I  should  like  to  tell  you  how  very  much  I  appreciate  the  note 
that  has  been  struck  here  several  times  about  not  slaughtering  good 
literature  to  teach  health.  We  surely  have  enough  imagination  today 
among  the  people  who  can  write  to  give  us  original  ideas  to  put  before 
the  children. 

"In  connection  with  the  use  of  stars,  I  feel  very  strongly  that  it  is 
absolutely  unnecessary  to  use  stars  in  stimulating  the  younger  chil- 
dren, and  I  was  particularly  glad  to  have  Miss  Abbot  bring  that 
out.     But  I  do  believe  that  competition  can  be  used  effectively  in 
Valid  connection  with  the  children's  weight  and  can  be  done  without  making 

Incentives,     them   self-conscious,  though   I   do  not  believe  it  necessary  to   add 
rewards." 

Miss  Haver  then  said : 

"We  have  found  that  competition  between  groups  and  rewards 
for  the  same  are  much  more  effective  than  between  individuals  and 
individual  rewards.  We  give  very  simple  rewards  to  individuals, 
perhaps  a  button,  but  for  the  group  rewards  a  banner  or  a  class 
certificate  is  given — something  that  they  all  want  or  are  all  proud  of." 

Miss  Dolfinger,  speaking  of  incentives,  other  than  ma- 
terial rewards,  said: 

"The  8th  grade  boys  and  girls  of  a  certain  school  are  very  anxious 
to  take  part  in  the  Athletic  Badge  Contests  of  the  Playground  Asso- 
ciation of  America.  They  are  not  allowed  to  take  part  in  these  con 
tests  unless  their  health  records  show  that  they  are  physicallj 
equipped  to  compete,  by  having  a  background  of  good  health  habits 
and  bodily  fitness.  To  reach  such  a  standard  has  been  a  real  incen 
tive,  since  they  recognize  the  validity  of  the  conditions  imposed,  an( 
want  to  meet  them." 

Miss  Mary  Spencer  told  of  her  experience  with  a  grou] 


101 


of  children  in  the  Horace  Mann  Scjipol,  Teachers'  College, 
saying:  ,  •  \  •/-'- 

"As  I  had  no  course  of  study,  I  had  simply  to  study  my  own 
group.  These  were  children  to  whom  such  things  as  taking  a  bath, 
etc.,  were  not  quite  so  essential,  as  they  were  accustomed  to  their 
morning  shower.  The  point  of  contact  I  had  to  make  was  with  the 
weighing  and  measuring.  There  are  underweight  children  in  the 
best  families.  On  an  average,  five  or  six  children  out  of  30  are 
10  per  cent,  underweight  for  their  height. 

"We  began  with  the  study  of  foods.  This  proved  quite  an  inter- 
esting point,  and  we  had  quite  a  competition  in  trying  to  bring  weight 
up  to  height.  We  organized  into  clubs  and  named  these  the  Giants, 
the  Ants  and  Columbia  Tigers,  as  these  were  quite  prominent  at 
that  time.  Right  through  the  entire  school  year  the  competition 
continued.  We  made  menus,  after  studying  food  subjects,  and  got 
our  background  in  that  way. 

"I  had  a  friend  who  did  not  like  to  drink  milk  and  I  told  the 
children  about  her.  We  were  all  anxious  to  show  her  why  she  should 
drink  milk.  We  all  wrote  her  letters  and  eventually  succeeded  in 
having  her  like  to  drink  milk. 

"It  is  quite  essential  to  make  health  fashionable. 

"Toward  the  end  of  the  year  we  tried  out  the  project  of  making 
a  health  book.  We  put  in  letters,  menus,  and  we  also  worked  in 
rhymes  and  stories,  and  correlated  them  as  much  as  possible  with 
English." 

Dr.  Mary  Brydon,  Director  of  the  Bureau  of  Child 
Welfare,  Virginia  State  Board  of  Health,  was  interested  to 
know  of  any  incentives  strong  enough  to  carry  health  prac- 
tices through  the  summer  vacation.  She  asked : 

"What  incentives  do  the  teachers  use  to  carry  the  habits  over  in 
the  vacation? 

"We  had  some  pre-school  clinics  during  the  vacation  and  all  the 
school  children  in  the  neighborhood  came  to  see  what  we  were  doing 
at  the  school  house.  Five  or  six  of  them  sat  on  the  front  benches 
as  I  examined  the  babies.  When  I  finished  with  the  babies  I  looked 
at  the  older  children's  teeth.  'Why,  your  teeth  are  so  dirty/  I  said. 
'Don't  you  clean  them?'  'No,  indeed/  was  the  reply,  'Teacher  has 
gone  away,  and  I  don't  have  to  clean  them.' " 


Projecting 
Interest 
in  Health 
into  the 
Summer 
Vacation. 


Miss  Haver  responded : 

"In  our  district  during  the  last  week  in  school  the  teachers  talk 
to  the  children  about  continuing  their  health  habits,  and  in  the 
first  week  in  September  they  ask  about  the  results  accomplished. 
The  care  of  the  teeth  has  in  most  cases  slumped.  The  number  of 
baths  taken,  however,  have  sometimes  increased  from  one  to  seven  a 
week,  because  the  children  have  had  more  opportunity  to  get  their 
baths." 


102 

t  Margaret  Sparks,  Nutrition  Specialist,  Trenton 
Public  School's,  'gave  another  answer : 

"I  spoke  to  my  classes  in  the  Open- Air  School  just  previous  to 
coming  here  in  regard  to  an  experiment  which  might  prove  helpful 
to  school  children  in  other  places — what  they  could  do  to  prove  to 
other  children  that  they  could  keep  their  weight  up  during  the 
summer.  They  drew  up  rules  that  they  thought  would  be  practical 
to  follow  up  this  summer.  They  are  going  to  take  them  home  and 
try  them  out,  and  in  September  we  are  going  to  find  out  the  results." 

Dr.  Wood  then  introduced  Miss  Mabel  Bragg,  Assistant 
Superintendent,  Newtonville  Public  Schools,  Newton,  Mass. 

Incentives  and  Motives  in  Health  Education 

Miss  Bragg: 

ONE  big  thing  I  have  learned  from  this  Conference 
is  how  much  we  all  need  each  other.  This  health 
work  with  the  children  means  all  kinds  of  people  working 
together  to  gain  a  scientific  knowledge  of  facts  and  to  gather 
together  a  body  of  material  that  will  help  us  all  along  the 
line  of  work  for  children,  and  for  the  general  health  of  the 
community.  It  means  an  organization  of  material,  and  the 
help  of  scientific  people  who  are  able  to  do  this.  It  means 
also  that  we  must  have  people  who  are  explorers  of  chil- 
dren's lives,  and  children's  interests  and  activities.  How 
are  we  going  to  get  over  to  the  lives  of  children  what  we 
think  it  well  for  them  to  know?  How  are  we  going  to  do 
this  piece  of  work  most  effectively? 

These  questions  bring  us  right  back  to  the  training  of 
teachers  in  knowledge  and  methods  and  understanding  of 
present-day  educational  problems.  Never  was  there  a  hap- 
pier time,  never  was  there  a  better  time  than  now  for  this 
work  to  be  carried  on  successfully,  because  all  Elementary 
School  work  is  being  changed.  No  longer  are  simply  the 
facts  of  the  fundamental  subjects — reading,  writing  and 
arithmetic — imposed  upon  the  children  as  just  so  much  to 
be  learned.  No  longer  are  they  given  mental  food  whether 
they  are  hungry  or  not,  but  the  interests  of  the  children  are 
studied,  their  undertakings  are  studied,  their  needs  are  un- 
derstood and  they  are  brought  into  contact  with  the  facts, 
the  information,  the  wealth  of  the  world's  knowledge,  as 
they  need  it  in  their  own  little  undertakings  in  the  home, 
in  the  Kindergarten,  in  the  Primary  School  and  on  up  into 


103 

the  grades.  We  hope  that  some  day  this  attitude  will  reach 
High  School  teaching  as  well — it  must — it  will  in  time! 
The  exploration  of  children's  needs  and  understanding  them 
is  the  acquiring  of  this  attitude. 

If  we  are  to  help  our  children  to  become  worthy  mem- 
bers  of  the  little  community  in  which  they  live,  we  must  for  Corn- 
study  not  only  past  and  future  values  but  immediate  needs,  mun 
They  need  health  and  practical  skill  and  efficiency ;  they 
need  to  know  the  school  subjects;  they  need  to  know  citizen- 
ship, which  to  them  means  living  together  in  their  com- 
munity, and  they  need  to  know  how  to  play. 

If  we  begin  in  the  Kindergarten  and  teach  a  wiser  use 
of  leisure,  we  shall  perhaps  teach  them  how  to  discover 
more  leisure,  and  that  would  certainly  be  a  blessing.  All 
these  things  we  are  doing  in  our  health  work  with  our  chil- 
dren. We  are  helping  them  to  see  their  needs;  and  their 
needs  in  the  beginning  are  the  formation  of  the  right  kind 
of  habits.  Little  children  do  not  thrive  on  principles ;  they 
thrive  on  habits,  but  the  time  will  come  when  they  want  to 
know  why  they  do  these  things  and  the  teacher  in  the  middle 
grades  must  be  able  to  teach  them  why.  The  teacher  in  the 
middle  and  upper  grades  must  teach  physiology  connected 
with  the  health  habits  of  her  children.  The  physiology  of 
the  lungs  is  much  more  fascinating  related  to  the  exercise 
and  fresh  air  habits.  Based  on  their  food  knowledge  and 
habits  the  study  of  digestion  is  a  subject  of  personal  inter- 
est. So  the  study  of  physiology  and  nutrition  as  an  out- 
growth of  their  personal  experiences,  and  closely  related  to 
them,  have  added  power. 

Let  us  not  fail  to  teach  our  physiology;  let  us  not  fail 
to  include  scientific  knowledge  in  our  teaching  of  health.  If 
anybody  believes  that  some  of  us  have  failed  along  these 
lines,  it  is  because  we  are  laying  our  foundations  and  bring- 
ing the  children  up  to  the  point  of  asking  "Why  is  this  so?" 
"Why  is  this  necessary?" 

We  educated  children,  once  upon  a  time,  that  they  might 
get  more  out  of  life.  Now  children  are  being  educated,  not 
only  for  their  own  sakes,  but  for  the  sake  of  the  community 
of  which  they  are  members,  for  the  home,  the  school,  the 
church,  the  city.  They  are  to  be  better  people  and  also 
better  members  of  their  community.  That  is  what  educa- 
tion means  today. 


104 

In  order  to  be  better  members  of  the  community  they 
must  be  physically  and  mentally  happy.  They  must  not  be 
"pepless,"  but  they  must  be  full  of  power  and  energy,  of 
life  and  happiness. 

"The  Faith !  The  Power  of  an  Idea !  Is  there  anything  more 

anfdecf"  wonderful?  The  children  in  one  of  our  schools  are  very 
much  interested  to  be  in  good  condition  in  September.  They 
are  having  a  campaign  to  keep  themselves  up  to  the  standard 
of  physical  fitness.  They  have  made  up  their  minds  that  the 
responsibility  is  a  big  one — to  keep  up  the  reputation  of  their 
community  during  the  summer.  They  have  decided  upon 
all  the  facts  to  which  they  need  to  give  attention,  and  they 
have  talked  about  why  these  things  are  necessary.  They 
have  worked  out  their  needs, — the  different  things  they 
must  do.  They  mean  to  help  themselves  through  these 
summer  days,  and  they  hope  to  keep  themselves  from  losing 
ground  if  it  is  possible.  When  they  come  back  in  Septem- 
ber we  are  going  to  have  an  account  of  efforts  made.  Here 
is  demonstration  of  the  power  of  an  idea  and  we  people  who 
are  working  with  these  little  children  are  getting  hold  of 
the  value  of  this  kind  of  teaching.  The  children  do  some- 
thing to  each  other  that  we  cannot  do. 

Another  illustration  of  what  can  be  accomplished  with 
children  through  the  power  of  an  idea  is  shown  in  the  way 
in  which  the  pupils  of  one  old  school  building  secured  im- 
provements. The  building  was  old  and  was  not  to  be  used 
much  longer,  but  the  children  concluded  they  needed  better 
conditions  for  their  work.  They  made  a  study  of  the  build- 
ing and  called  it  a  survey — they  made  beautiful  posters  for 
the  halls  and  rooms  showing  graphically  improvements  thai 
would  make  their  old  building  a  better  place  for  childrer 
to  live  in.  The  community  became  interested  and  condition* 
were  greatly  improved.  The  new  building  will  be  providec 
sooner  than  it  might  have  been  because  of  the  power  of  ai 
idea. 

How  are  we  going  to  get  teachers  to  do  this  work?  Ho\ 
are  we  going  to  get  school  administrators  to  give  us  tim  s 
to  do  it?  Some  of  the  things  we  need  are  understandin  • 
and  tolerance  and  rejoicing  that  so  many  people  along  s  » 
many  lines  are  united  on  this  one  great  need — the  healt  i 
of  our  children.  They  all  come  with  their  contributior  5 
for  the  good  of  all.  We  need  better  organization  of  mat<  - 
rial  and  we  need  experts  with  the  children.  We  need  tt  3 


105 

wisest  people  who  will  contribute  scientific  content.  We 
need  the  best  of  teachers  who  know  children  and  method 
and  subject  matter,  and  who  exemplify  their  knowledge  in 
their  lives.  We  need  teachers  who  will  give  attention  to 
the  individual  needs  of  the  individual  children;  who  are 
willing  to  throw  away  past  mistakes  rejoicing  that  "This 
is  a  new  day." 

In  Teacher-Training  Schools  greater  emphasis  will  be 
placed  upon  the  personal  health  habits  of  the  students  that 
they  may  experience  what  they  will  later  teach.  New 
knowledge  and  better  health  habits  will  prepare  our  teach- 
ers better  to  meet  the  new  opportunities  of  Health  Educa- 
tion for  children. 

Discussion 


Dr.  Wood  then  introduced  Miss  Mary  A.  S.  Mugan, 
Assistant  Superintendent  of  Schools,  Fall  River,  Mass.,  to 
discuss  Miss  Bragg's  remarks. 

Miss  Mugan: 

"The  strongest  incentive  in  Health  Education  is  the  increased  Service 
possibility,  the  greater  potentiality  for  service.     This  is  the  motive  (jsant. 
which  makes  a  strong  appeal  to  teachers.    As  they  study  a  plan  for     ^ 
Health  Education  and  as  they  get  it  into  action  with  their  children 
they  are   stirred  to  genuine,  worthy  accomplishment  because  they 
realize  the  tremendous  opportunity  that  is  theirs. 

"In  the  child's  mind,  too,  when  Health  Education  is  carried 
through  the  grades  with  enthusiasm  intelligently  directed,  two  ideas 
are  gradually  but  definitely  developed — first,  that  he  must  have 
a  sound  body,  so  that  he  may  be  ready  to  do  his  share  of  the  world's 
work;  second,  good  health  will  make  him  fit,  and  will  add  to  his 
enjoyment  of  his  vocation  and  of  his  play.  But  no  man  may  live  for 
himself  alone  and  his  health  education  shows  him  how  he  may  help 
in  many  phases  of  community  welfare. 

"Just  here  I  wish  to  emphasize  one  point  that  has  been  made 
by  more  than  one  speaker.  Cardinal  Newman,  in  one  of  his  forceful 
essays,  has  a  strong  passage  on  the  value  of  judicious  repetition. 
We  must  repeat  and  drive  home  again  and  again  that  the  real  test 
of  all  this  Health  Education  is  found  in  the  answer  to  this  question, 
Is  it  functioning  in  the  daily  life  of  the  child?  Is  it  carried  over  into 
the  homes? 

"The  members  of  this  Conference  would  not  be  here  if  they  did 
not  have  enthusiasm  for  Health  Education  as  well  as  knowledge  and 
skill  in  certain  phases  of  it.  But  one  of  the  biggest  pieces  of  work 
this  body  of  enthusiasts  can  do,  is  to  devise  ways  and  means  to  get 
an  ardent  and  active  interest  in  this  work  among  the  superintendents 
and  supervisory  officials  of  school  departments  throughout  the  country. 


106 


Interest 
of  School 
Adminis- 
trators 
Indispen- 
sable. 


Although  the  dire  need  of  this  type  of  education  has  been  urged  by 
educators  from  Horace  Mann  to  those  of  our  time,  the  grip  of 
formalism  has  very  generally  contracted  the  institution.  In  this 
new  era  of  vital,  intimate  teaching  that  gets  into  the  daily  school 
life  and  home  life,  school  administrators  must  see  their  opportunity 
to  stimulate  the  organization  of  intelligent  health  movements.  They 
must  find  the  way  to  show  teachers  how  to  help  themselves  to  develop 
and  grow  in  power  in  this  work.  They  must  put  into  operation 
a  definite  program  and  curriculum,  but  they  must  leave  the  teacher 
free  to  adapt  her  plans  to  the  needs  of  her  class,  which  only  she 
can  know. 

"In  closing  I  must  pay  my  meed  of  appreciation  to  the  leaders  of 
this  Conference  who  themselves  combine  vision  and  idealism  with 
sane,  practical,  workable  knowledge  and  skill  in  many  phases  of 
this  most  important  type  of  education.  From  this  meeting  should 
come  very  definite  and  widespread  results  that  will  be  felt  in  ever 
widening  circles  in  all  the  school  systems  of  this  country.  For 
the  sake  of  the  children  we  hope  that  that  day  may  come  soon." 


An  Incen- 
tive for 
Teachers. 


Repetition 
Essential 
to  Health 
Habit 
Formation. 


Miss  Belle  Kirk,  Social   Service   Union,   Steubenville, 
Ohio,  spoke  of  incentives  for  teachers.    She  said : 

"While  we  are  not  officially  in  the  public  schools,  we  have  the 
permission  of  superintendents  and  principals  of  schools  to  give  a 
prize  to  the  teacher  who  will  make  the  best  physical  improvement 
in  her  children  between  the  first  of  February  and  the  end  of  the 
school  year.  We  have  ten  schools — three  of  them  foreign.  All  of 
the  ten  principals,  but  two,  gave  permission  and  have  allowed  the 
teachers  to  carry  on  this  health  campaign.  Most  of  the  teachers 
went  to  work  enthusiastically,  and  the  result  has  been  really  wonder- 
ful. The  prize  which  was  offered  to  the  teachers  was  not  a  money 
prize,  but  a  trip  which  was  to  give  her  some  real  benefit,  and  as  the 
schools  are  so  largely  foreign  and  there  is  so  much  uncleanliness, 
it  has  been,  as  you  can  imagine,  a  transformation  and  it  has  benefitted 
all  who  have  gone  in  for  it." 

Mr.  DeForest  referred  to  an  important  aspect  of  health 
training,  saying: 

"One  word  of  many  good  ones  that  Miss  Mugan  said  came  par- 
ticularly close  to  my  heart,  the  word  'repetition.'  We  are  holding 
up  as  a  goal  the  acquisition  of  good  health  habits.  Too  many  of  us 
do  not  stop  to  analyze  the  underlying  law  of  habit  formation.  If 
I  were  asked  to  write  it  out  I  should  define  it  in  four  rules.  First, 
interest  must  be  aroused;  second,  action  must  be  obtained;  third,  in- 
terest must  be  sustained  and  sustained;  fourth,  action  must  be  re- 
peated and  repeated  and  repeated — repetition  is  the  word  that  counts. 
It  is  the  very  essence  of  habit  formation.  Can  any  one  point  out  how 
a  habit  can  be  formed  without  repetition?  In  arousing  interest,  a 
distinction  should  be  made  between  the  interest  in  prospect,  and  the 
interest  in  practice.  It  is  very  easy  to  arouse  interest  in  prospect 


107 

without  getting  practice  even  once.  We  like  attractive  books,  beau- 
tiful pictures,  interesting  stories.  They  are  necessary  to  arouse 
interest  and  may  even  get  action  once,  but  we  must  remember  that 
without  a  follow-up,  interest  may  'peter'  away  and  the  last  state 
may  be  worse  than  it  was  at  first — if  interest  is  not  followed  up 
and  sustained  with  action.  In  applying  our  law  of  habit  formation 
we  should  keep  in  mind  always  the  principles  of  child  psychology. 
The  most  important  ones  are  these:  Every  child  wants  to  play. 
Every  child  wants  to  come  up  to  a  record.  Every  child  wants  to 
play  that  he  is  grown  up  and  is  doing  things  worthy  of  a  grown-up. 
.  .  .  You  will  observe,  I  am  sure,  that  each  one  of  these  principles 
can  be  impressed  by  a  method  of  indirect  motivation.  The  child  cannot 
be  directly  interested  in  health  as  a  present  abstract  or  future 
benefit." 

In  connection  with  Miss  Mugan's  statement  that  it  is 
necessary  to  enlist  the  interest  of  the  superintendents,  Miss 
Pritckett  made  the  point  that  many  superintendents  are 
already  interested.  They  are  hampered,  however,  by  a 
lack  of  community  backing  which  would  justify  them  in 
setting  aside  school  funds  for  this  purpose.  One  way  of 
securing  this  community  backing  is  by  arousing  the  interest 
of  the  Women's  Clubs.  Continuing,  she  said: 

"We   are   trying   a   little    plan   in    Pennsylvania    that   has   been   Securing 
worked  out  through  the  State  Department  of  Health  and  the  Public   the  Coop- 
Welfare  Department,  with  which   we  have  the   closest  cooperation.    fp^^'s 
We  organized  first  a   Commonwealth   Committee  that  travels   over    clubs. 
the  State  and  from  that  we  developed  an  organization  whereby  the 
county  women  may  be  organized  in  groups,  each  group  standing  back 
of  a  school  and  first  equipping  that  school  and  making  it  possible  to 
teach  Health  Education  there,  because  50  per  cent,  of  the  rural  schools 
are   not   equipped    for   the   teaching    of    Health    Education.      After 
equipment  of  the  school,  they  then  place  in  it  some  form  of  Health 
Education,  beginning  usually  with  the  school  lunch.     This  was  vir- 
tually inspired  by  the  women  in  the  State,  and  before  the  organization 
was  complete  three  counties  had  called  for  it.     We  now  have  three 
counties   working  for  the  equipment  of  these  schools.     The   school 
superintendents   will   not   consider   that   a    fad.     Their   women   are 
demanding  it." 

Dr.  Brown: 

"A   real  question  arises  in  connection  with   stimulating  a   com-  Propaganda 
munity's  interest,  not  in  the  matter  of  equipment,  such  as  scales  alone, 
but  in  all  public  health  matters.     We  have  been  using  the  willing- 
ness  of  a  community  to  do  things  we  believe  to  be  effective,  without   Follow-up. 
providing  the  means  of  following  up,  or  the  personnel  to  carry  out  this 
plan    in   the   community.      We   work   this    community   to   the   point 
where  the   Women's   Clubs  buy  the   scales   or  other   advised   equip- 
ment; but  without  anything  else  being  done  the  thing  simmers  down 
and  the  next  time  we  try  to  induce  them  to  buy  a  scale  we  have  a 


108 

harder  time.  We  must  help  them  to  follow  through,  not  only  with 
personnel,  but  with  the  possibility  of  carrying  through  that  thing 
in  the  community." 

Successes  and  Failures 


THE  papers  next  in  order  are  accounts  of  successes 
or  failures  met  with  by  various  workers,  and 
here  described,  and  to  some  extent  analyzed  for 
the  benefit  of  the  Conference.  The  first  such  account  was 
prepared  by  Miss  Maud  Brown,  of  the  Elizabeth  McCor- 
mick  Memorial  Fund,  Chicago,  one  of  our  well  trained 
scientific  workers  and  an  enthusiast  in  the  health  field.  She 
has  done  some  outstanding  work  in  Kansas  City,  is  helping 
to  conduct  a  demonstration  in  connection  with  the  Elizabeth 
McCormick  Memorial  Fund  in  Oak  Park,  111.,  and  is  now 
doing  research  work  at  the  Iowa  Child  Welfare  Research 
Station. 

Successes  and  Failures  in  Teaching  Health  Habits 

Miss  Brown: 

IT  is  a  poor  time  for  me  to  be  discussing  "failures  and 
successes"  in  teaching  health  habits,  for  the  simple  rea- 
son that  my  investigations  seem  to  have  brought  me  to  a 
point,  just  now,  where  it  seems  scarcely  possible  to  dis- 
tinguish between  success  and  failure.  I  am  in  a  state  of 
suspended  judgment  about  everything.  But  I  am  not  dis- 
couraged— was  never,  indeed,  so  far  from  discouragement. 
This  year  the  Elizabeth  McCormick  Memorial  Fund  has 
given  me  the  opportunity  of  digging  up,  turning  inside  out, 
and  pulling  apart  every  method  of  procedure  which  I  have 
tried  within  the  past  few  years.  I  have  especially  scruti- 
nized the  plan  which  I  developed  with  the  splendid  help  of 
Miss  Jean,  in  Kansas  City.  Now,  under  the  friendly  and 
critical  eye  of  Dr.  Baldwin,  of  the  Iowa  Child  Welfare 
Research  Station,  we  are  tabulating  these  data;  and  it 
will  go  hard  with  me  if  from  these  neat  rows  of  figures 
and  letters  growing  at  the  tips  of  our  fountain-pens,  there 
does  not  emerge  some  significant  correlation  which  will 
act  as  a  precipitant  to  my  murky  mind.  One  of  the  satis- 
fying things  about  scientific  work  is  that  there  is  no  gamble 
in  it.  If  the  work  is  honest,  something  is  bound  to  come 
out  of  it — if  not  a  correlation,  then  a  lack  of  correlation. 


109 

By  this  time  next  year,  consequently,  I  shall  have  some- 
thing,— I  don't  know  what. 

The  most  fortunate  of  my  experiences  of  the  past  few 
years,  is  that  the  intensive  health  study  of  the  children  of 
the  small  school  with  which  I  started  my  work  in  Kansas 
City  was  made  in  the  spring.  Ever  since,  it  has  kept 
my  fingers  crossed  in  the  face  of  large  gains — I  mean 
large  alterations  in  the  weight-height  ratio.  In  those 
studies  where  the  figures  run  from  September  to 
June,  and  where  there  has  been  considerable  reduc- 
tion of  percentages  of  underweight  pupils,  my  fingers 
automatically  cross  themselves  as  my  mind  recalls  the 
struggle  which  that  most  devoted  and  able  group  made  to 
get  a  few  paltry  pounds  on  the  demonstration  group — in  the 
early  spring.  The  pounds  came,  but  as  the  result  of  a  com- 
pleteness of  health-service  and  cooperation  that  is  at 
present  impossible  of  attainment  for  the  great  numbers  of 
school  children. 

Now,  for  the  first  time,  there  are  accumulating  some 
consecutive  bodies  of  measurements  for  periods  of  twelve 
months  at  a  time.  This  year  I  had  the  very  interesting 
experience  in  comparing  the  three  years'  records  of  Kansas 
City  and  the  two  years'  records  of  Newton  to  find  the  same 
rhythm!  The  methods  used  in  the  two  places  are  widely 
different,  yet  some  divinity  seems  to  be  shaping  the  ends  of 
those  weight  curves  so  that,  thus  far,  they  come  back  in 
September  to,  allowing  for  normal  variation,  the  starting 
point  of  the  September  previous.  But  two  school  systems 
— some  forty-six  thousand  children  altogether — aren't 
enough  to  draw  conclusions  from.  If  the  gentleman  from 
East  Orange,  N.  J.,  will  allow  us  to  keep  on  measuring  and 
weighing  school  children  for  a  few  years  longer  we  shall 
eventually  accumulate  a  sufficiently  large  body  of  data  to 
base  conclusions  upon. 

However,  the  extensive  data  (necessarily  depending 
upon  their  numbers  for  authenticity)  of  a  large  school  sys- 
tem continued  year  after  year,  supplemented  by  the  inten- 
sive data  (depending  for  their  value  upon  exceeding  care 
in  controlling  conditions  and  measurements)  of  a  small 
system,  should  give  results  of  some  value.  Now,  if  in 
October,  the  end  of  the  first  twelve  months,  the  fluctuation 
of  the  growth  curves  of  this  school  system  follows  the  same 
rhythm  already  evidenced  by  Kansas  City  and  Newton,  it 


110 


Definite 
Mistakes. 


will  mean  something — the  next  step  will  be  to  find  out 
what.  To  that  end  the  correlation  of  various  measurements 
and  traits  is  already  under  way. 

Meanwhile,  there  are  two  successes  that  I  am  sure  of, 
no  matter  how  the  weight  curve  of  the  children  behaves. 

First  and  best,  is  the  work  of  Miss  Bragg's  teachers  in 
Newton,  Mass.,  which  I  saw  this  spring.  The  way  in  which 
she  has  infused  her  spirit  into  her  whole  teaching  staff, 
making  each  teacher  devoutly  to  desire  health  for  every 
child,  is  the  finest  thing  I  have  ever  seen.  Those  who  have 
worked  in  any  supervisory  capacity  with  teachers  know 
that  it  would  be  impossible  to  prevent  the  work  from  be- 
coming perfunctory,  were  it  not  productive  of  real  good  to 
the  children,  which  is  clearly  evident  to  the  teachers.  Au- 
thority can  command  observance,  but  it  cannot  evoke  the 
enthusiasm  which  shines  out  of  the  eyes  of  Miss  Bragg's 
teachers.  Then  no  matter  what  the  curve  does  in  Septem- 
ber— their  teaching  of  health  habits  is  a  success. 

Just  so  in  another  village  of  the  same  size — I  know, 
a  priori,  irrespective  of  the  behavior  of  any  red,  white,  and 
blue  lines,  that  when  hundreds  of  homes  alter  their  health 
program  to  an  earlier  bedtime,  more  milk,  less  candy,  more 
greens — that  it  is  good. 

The  greatest  success  which  has  ever  been  made  in 
teaching  health,  it  seems  to  me,  is  the  Child  Health  Organi- 
zation scheme  of  the  Classroom  Weight  Record  and  tag. 
We  must  pull  the  operation  of  the  scheme  through  the 
critical  period  corresponding  to  the  baby's  "second  sum- 
mer"— when  children  who  have  been  trying  for  months  to 
come  up  to  weight  and  have  made  real  sacrifice  based  upon 
our  assurance  that  the  scales  would  show  the  difference, 
see  certain  wicked  lolly-pop  eaters  flourishing  like  green 
bay  trees — and  the  righteous  who  eschew  the  picture-show 
at  night  cast  down — a  pound  or  more.  Who  is  not  familiar 
with  "I  eat  pickles  and  drink  coffee  and  am  up  to  weight," 
or  "I  drink  milk  and  go  to  bed  early — why  don't  I  gain?" 

On  the  other  hand,  there  are  some  mistakes  to  be 
avoided. 

First:  It  is  a  mistake  to  teach  a  few  disconnected  health  essen- 
tials. (James  2:10 — Now  we  will  see  who  brought  their  Bibles). 
The  child  who  drinks  water  freely  will  not  be  saved  if  he  lose  sleep. 
He  who  drinks  milk  must  also  eat  bulk.  He  who  plays  out  of  doors 
needs  to  breathe  through  his  nose.  The  whole  health  program  must 


Ill 

be  taught  as  a  unit  of  behavior.  It  has  the  advantage  of  being 
much  more  easily  remembered  if  it  hangs  together  chronologically. 

Second :  It  is  a  mistake  to  teach  reasons  to  small  children,  and  an 
equal  mistake  not  to  teach  them  to  older  ones  (from  12  years  up). 
Of  course  it  is  impossible  to  teach  them  the  correct  reason — since  we 
do  not  know  the  reasons  for  many  of  the  simplest  essentials.  I  used 
to  believe  that  it  is  better  not  to  teach  any  reason  than  to  risk  teaching 
a  false  one.  I  have  come  to  believe  that  it  doesn't  much  matter 
whether  the  reason  is  true  or  not,  so  long  as  the  fact  is  sound.  But 
we  must  protect  that  boy  from  the  ignominy  of  basing  his  conduct 
upon  the  opinion  of  the  teacher — a  mere  woman!  He  must  have  the 
printed  page.  At  the  rate  at  which  biological  science  is  progressing 
at  present  all  our  present  reasons  will  be  of  historic  interest  only  by 
the  time  he  is  old  enough  to  discriminate. 

I  have  recently  collected  five  perfectly  good  and  true  reasons 
why  a  child  should  not  eat  candy  between  meals.  These  reasons 
came  from  a  pediatrist,  a  physiological  chemist,  a  physical  chemist, 
and  a  biologist.  It  does  not  matter  which  of  the  five  reasons  the 
teacher  gives,  so  long  as  the  child  can  see  that  it  is  written  in  a 
book,  but  some  reason  must  be  given. 

The  real  reason  why  the  teaching  of  health  is  so  difficult 
a  problem  for  the  public  school  teacher  is  that  she  ought  Swamped 
never  to  have  it  to  do.    It  should  not  be  necessary  to  teach  byl(£°t™~  o 
the  child  to  play  out  of  doors,  to  rest  when  he  is  tired,  to  Modem.0" 
drink  water  when  he  is  thirsty,  any  more  than  to  teach  him  Life- 
to  tell  the  truth.    The  real  health  essentials  are  simple  and 
instinctive.    The  real  difficulty  lies  in  protecting  the  child 
from  the  man-made  complexities  of  our  modern  life. 

The  teaching  of  health  is  not  comparable  with  the  teach- 
ing of  any  other  subject  in  the  curriculum.  One  reason 
for  our  failure  is  that  since  we  have  been  giving  thought 
to  it  at  all,  we  have  been  trying  to  work  it  out  as  one  of  the 
regular  content  subjects,  as,  for  example,  history. 

Health  and  ethics,  only,  belong  together.  They  present 
the  same  difficulties,  they  require  the  same  method.  They 
are  incomparably  the  most  important  part  of  the  teacher's 
work — as  well  as  the  most  difficult.  Both  health  and  ethics 
demand  the  habitual  observance  of  a  very  few  procedures. 
These  being  instinctive,  require  no  skill  in  the  performance, 
no  background  of  information.  The  virtues  and  the  essen- 
tials of  health — their  simplicity  and  their  axiomatic  quality 
— is  their  source  of  difficulty  to  the  classroom  teacher. 

A  child  is  in  a  bad  way  if  he  does  not  develop  the  habit 
of  truth  telling  until  his  mind  is  able  to  follow  the  mazes  of 
the  philosopher  who  seeks  to  tell  us  why.  The  child  must, 


112 

likewise,  have  the  reactions  to  his  environment  which  are 
necessary  for  healthy  functioning  of  his  body  built  into  his 
tissues  long  before  he  is  able  to  understand  why.  I  do  not 
like  to  be  a  wet  blanket,  and  I  would  not  say  many  things  in 
a  general  meeting  which  I  am  talking  out  here.  I  do  not  be- 
lieve in  destroying  an  orthodox  tenet  until  something  which 
works  as  well  is  ready  for  substitution.  But  the  longer  I 
work  on  this  problem  the  stronger  my  feeling  is  that,  do 
as  much  as  we  may,  we  have  not,  so  far  at  least,  greatly 
modified  for  the  better  the  conditions  of  the  material  which 
is  turned  over  to  us  at  five  or  six  years.  It  may  mean  "mal- 
observation"  on  my  part — I  hope  so.  It  may  mean  that  the 
material  is  largely  "set"  by  that  time  and  that  we  are  ap- 
plying our  efforts  at  the  wrong  fulcrum,  or  it  may  mean 
that  we  are  essentially  on  the  right  track  but  have  not 
sufficiently  concentrated  and  intensified  our  efforts. 

The  teacher  is  UP  a£ainst  exactly  the  problem  of  the 
and  Moral  preacher,  the  endless  iteration  of  a  few  simple  truths.  The 
Education,  health  essentials,  like  the  virtues,  "when  mouthed,  become 
trite :  when  constantly  reiterated,  lose  their  freshness :  when 
rubbed  into  the  surface  of  consciousness,  cause  irritation." 
I  am  the  more  convinced  the  more  I  contemplate  my  failures 
in  teaching  health,  that  the  whole  thing  is  a  moral  problem. 
I  am  quoting,  by  the  very  kind  permission  of  the  chairman, 
Dr.  Starbuck,  from  the  manuscript  of  the  report  on  a  plan 
for  moral  education  which  recently  was  declared  the  twenty 
thousand-dollar  prize  winner.  It  might  just  as  well  be 
entitled,  "A  Plan  of  Health  Education." 

"During  the  early  years,"  this  report  continues,  "reduce  self-con- 
scious goodness  and  reasoned  conduct  to  a  minimum.  Don't  tempt  the 
child  to  analyze  the  moral  life  until  he  has  one.  First,  conduct;  then 
sympathies;  next,  the  imagination;  and  finally,  reasoned  behavior. 
To  organize  the  feelings  into  higher  ethical  sentiments.  To  attain 
conscious  self-control  and  help  to  direct  wisely  the  life  of  the  group." 

In  reading  Dr.  Starbuck's  manuscript,  I  was  so  struck 
with  the  identity  of  the  two  problems  that  I  am  making  a 
hasty  application  of  this  plan  of  moral  education  to  the 
teaching  of  health.  It  is  worth  long  and  careful  thought, 
I  believe. 

"First,  conduct," — simply  doing  the  desirable  thing. 
The  child  has  the  right  to  a  sound  and  simple  daily  health 
regimen.  It  is  his  inalienable  right,  years  before  he  can 
reason  out  the  whys  of  a  healthful  diet,  to  be  provided  with 


113 

one.  It  is  all  wrong  when  we  at  school  must  needs  put  the 
child  up  to  registering  a  protest  against  his  parents'  man- 
agement of  his  health  program.  Better  use  every  means 
within  our  power  to  have  the  initiative  ostensibly  proceed 
from  the  parent.  The  most  successful  primary  teacher  of 
health  habits  is  the  one  who  uses  the  telephone  most  freely, 
who  has  the  most  mothers'  meetings.  Mothers  are  quick  to 
appreciate  the  difference  between  the  teacher's  using  her 
influence  to  reinforce  the  home  precepts,  and  using  the 
same  authority  to  provide  the  child  with  ammunition  still 
further  to  bombard  the  all  too  frail  walls  of  parental 
authority. 

The  clever  teacher  will  usually  succeed  in  convincing 
the  mother  that  the  initiative  is  her  own,  and  the  difference 
between  the  resultant  of  forces  pulling  together  and  the 
same  forces  at  right  angles  will  show  so  plainly  in  the  well- 
being  of  the  child,  that  she  will  be  repaid  for  the  extra 
thought. 

The  young  child  has  the  inalienable  right  to  healthful 
physical  and  moral  surroundings.  And  it  should  be  more 
the  part  of  the  primary  teacher  to  strive  to  secure  these 
for  him  by  home  cooperation  than  to  coach  him  to  rebel 
against  the  home  regime.  "The  child's  moral  muscles,  like 
those  of  his  body,"  to  quote  from  the  same  manuscript,  "are 
for  use — not  for  analysis."  And  the  next  golden  sentence 
might  have  been  written  from  the  standpoint  of  physical 
health  as  well  as  moral:  "The  normal  impulses  must  be 
planted  in  the  muscles  of  children,  rather  than  flow 
smoothly  across  the  lips."  All  teachers  know  the  ease  with 
which  the  recitation  of  the  health  essentials  flows  across 
the  lips.  But  how  to  motivate  the  work  so  that  the  muscles 
gesture  instant  refusal  of  the  proffered  lolly-pop?  Aye — 
there's  the  rub !  All  health-habit  teachers  have  learned  the 
mathematical  truth  that  the  quickness  of  the  reaction  is  in 
direct  ratio  to  the  proximity  of  the  reward. 

We  are  constantly  demanding  action  from  the  children  A  Health 
oh  an  ethical  plane  higher  than  our  own.    How  many  of  us  Motivation 
are  capable  of  constant  sacrifice  of  present  pleasure  to     eque 
future  good?     How  many  times  do  we  say,  "I  suppose  I 
really  shouldn't— but—  ?" 

First,  then,  comes  conduct ,~  the  child  does  right  because 
it  is  the  path  of  least  resistance — fulfills  the  health  essen- 
tials because  it  is  made  a  part  of  his  environment.  He  does 


114 

the  right  thing  because  it  is  there  to  do  and  the  wrong  one 
isn't. 

"Second,  sympathies" — his  environment  becomes  im- 
mensely complicated  on  entering  school.  Avenues  of  choice 
open  to  him.  The  path  of  least  resistance  is  sometimes  the 
wrong  one.  Here  the  appeal  is  to  be  made  to  his  sympa- 
thies. He  loves  his  parents  supremely  and  his  teacher  is  a 
glorified  being  who  puts  to  shame  our  own  conceptions  of 
Deity.  The  strongest  appeal  to  right  conduct  is  the  desire 
for  their  approbation  or  the  sympathy  of  an  admired 
companion. 

"Third,  the  imagination"— the  most  difficult  stage  for 
the  average,  and  the  most  delightful  for  the  specially  called 
teacher.  The  creation  of  ideals  of  health  and  beauty  and 
goodness — just  to  stuff  the  storehouse  of  the  mind  full  of 
this  raw  material,  waiting  for  the  fourth  stage,  "reasoned 
conduct,"  to  build  its  standards  from;  for  "That  which  the 
child  in  later  years  thinks  is  right,  will  be  in  terms  of  that 
which  he  has  done  and  admired."  Applying  Professor 
Starbuck's  words  to  health  teaching,  in  the  fourth  stage  he 
learns  the  facts  which  will  explain  the  conduct  and  the 
altruistic  other-ward  uses  for  this  strength  of  body.  But 
his  early  performances,  strengthened  by  his  sympathies 
and  burned  into  indelibility  by  the  fires  of  his  young  imagi- 
nation, determine  the  course  of  this  reasoning. 

For  example,  take  one  item  which  is  the  source  of  a 
large  percentage  of  our  failures  in  teaching  health  habits, 
the  eating  of  sweets  between  meals,  and  see  at  what  wide 
variance  with  the  admirable  course  of  procedure  outlined 
above,  is  our  actual  treatment  of  the  child. 

A  Typical          "First,— simple  conduct"— the  child  must  be  protected 

Cycle  of  . . .    . , 

Failures.      during  his  pre-school  age  by  being  provided  with  the  proper 

diet.  This  is  a  task  the  most  difficult.  Grandpa  slips  him 
surreptitious  peppermints.  Aunt  Mabel  treats  him  to  an 
ice  cream  cone.  Adults  one  and  all  conspire,  by  their 
grimaces  of  pleasure  when  offering  the  baby  sweets,  by  the 
custom  of  conferring  candy  as  a  reward  or  withholding  it 
as  a  punishment,  to  develop  what  they  label  a  "natural 
craving"  for  candy.  When  he  has  finally  run  the  gauntlet 
of  adoring  adults  up  to  his  fifth  year  he  comes  to  school  and 
is  taught  by  the  children  the  desirability  of  the  candy  from 
the  little  store  opposite  the  schoolhouse. 


115 

It  is  a  hard  thing  to  say,  but  most  schools  serving  noon 
lunches  capitalize  this  adult-taught  desire  for  sweets  by  en- 
couraging them  to  buy  the  candy  which  is  the  profitable 
item  of  the  menu — for  the  principal  needs  to  replenish  her 
contingent  fund.  Candy  sales  are  a  common  and  abhorrent 
practice  in — I  am  afraid — most  school  systems.  The  child 
carries  home  a  red  weight  tag,  carrying  on  it  the  prohibi- 
tion concerning  candy  between  meals,  but  at  the  same  time 
munching  the  "good  homemade  fudge"  or  the  "pure  butter- 
scotch" which  helps  buy  a  new  piano  for  the  gymnasium. 
I  am  sorry,  but  I  am  not  drawing  an  unusual  or  an  extreme 
picture.  Teacher  has  lovely  posters  on  the  wall  illustrating 
the  health  habits.  They  all  read  a  beautiful  health  story 
by  Dr.  Andress  about  the  dangers  of  "Lolly-pop-town." 
Teacher  may  even  be  consistent  enough  to  wait  until  the 
children  are  at  recess  to  pass  to  her  next  door  colleague  her 
weekly  five-pound  box  of  chocolates  from  "him."  The  chil- 
dren are  measured  and  weighed — the  candy  eater  may  be 
the  proud  possessor  of  a  white  card  and  he  who  denies  him- 
self remain  in  the  group  of  losers. 

Second,  sympathies — he  gets  to  High  School  and  has  his 
first  "case."  The  book  of  etiquette  which  he  borrows  and 
hides  underneath  his  mattress  tells  him  that  his  gifts  may 
be  books,  flowers,  or  candy.  And,  of  course,  books  and 
flowers  eliminate  themselves  at  once  from  consideration.  In 
vain  may  the  High  School  physiology  teacher  expatiate  upon 
the  effect  on  the  complexion  of  candy  eating.  Edythe  gives 
a  satisfied  smile  into  her  vanity-case  mirror  as  she  abstracts 
a  plump  bitter-sweet,  then  touches  up  her  lips  with  her  lip 
stick.  What  matter  to  her  what  her  complexion  will  be  at 
twenty-five?  She'll  be  as  good  as  dead  by  that  time — so 
old  it  won't  matter. 

The  one  constructive  step  we  have  taken  in  teaching 
this  particular  health  habit  is  the  serving  of  mid-session 
milk,  so  that  the  satisfied  cells  do  not  pull  longingly  toward 
the  candy  counter  on  release  from  school. 

What  is  the  answer  to  the  whole  baffling  situation?  As  A  Possible 
I  said  in  the  beginning,  I  don't  know.    Yet  I  am  sure  of  Way  Out- 
two  things:  One  is  that  the  first  step  in  the  program  of 
moral  education  mapped  out  by  Professor  Starbuck  and  his 
co-workers,  is  the  absolute  sine  qua  non  of  health  teaching, 
that  the  whole  thing  is  hopeless  if  the  pre-school  child 
cannot  have  his  normal  instincts  conserved  until  he  enters 


116 


Biological 
Need  in 
Conflict 
with 
Modern 
Environ- 
ment. 


school.  This  stage  of  protection  while  he  learns  the  "doing 
of  the  deed"  being  granted  him,  it  is  relatively  easy  to  get 
him  through  the  second,  where  his  love  of  parent  and 
teacher  makes  the  desire  for  their  approval  greater  than 
his  longing  for  the  forbidden  fruit. 

From  this  he  passes  into  the  third  stage,  where  his  im- 
agination is  set  on  fire  and  his  ambition  stirred  by  heroic 
tales.  Thence  to  the  fourth,  when  he  is  given  the  material 
and  the  training  for  a  reasoned  planning  of  his  own  per- 
sonal and  community  health  program. 

All  this  time  that  I  have  been  seeking  a  way  of  teaching 
health  habits  so  that  children  may  be  healthier,  I  have  felt, 
and  increasingly,  the  presence  of  something  grim  and  un- 
yielding deep  underneath.  I  think  it  is  this : 

The  present-day  child  is  caught  between  the  upper  and 
the  nether  mill-stones  of  biology  and  modern  society.  The 
"irresistible  body"  of  economic  pressure  meets  the  "immov- 
able body"  of  biological  structure — and  the  child  is  caught 
between.  The  child  is  paying  in  the  most  precious  coin. 

The  structure  of  the  human  body  is  the  same  now  as  it 
was  back  in  the  days  of  ancient  Greece,  when  school  meant 
literally  "a  place  of  leisure."  Biologically,  today  is  only  an 
hour  removed  from  the  days  when  Plato  and  his  pupils 
sauntered  beneath  the  plane  trees — at  "school," — but  so- 
cially, who  can  measure  the  distance?  The  human  eye,  for 
example,  is  the  same  structure  which  served  primitive  man. 
The  muscles  of  accommodation  which  adjust  the  focus  of 
the  lens  were  contracted  only  occasionally  as  when  the 
hunter  had  need  sharply  to  define  his  prey.  Then  one  day 
a  man  back  in  the  Middle  Ages  had  an  inspiration — and, 
in  a  moment — society  demands  that  these  fine  muscles  pull 
hour  after  hour,  upon  the  lens,  holding  it  focused  upon 
millions  of  little  black  marks  upon  white  pages.  For 
twentieth  century  relaxation  it — the  same  biological  struc- 
ture that  it  was  before  the  printing  press — is  taken  into  a 
dark  room,  directed  toward  a  bright  screen  and  fixed  with 
all  the  intensity  the  child's  mind  can  command  upon  the 
effort  to  hold  still  the  rapidly  passing  figures  upon  a  flicker- 
ing screen — while  the  child-mind  takes  in  the  absorbing  de- 
tails of  the  society  triangle.  The  same  slender  white  nerves 
with  the  same  inability  to  store  nourishment  for  protracted 
demands  have  to  hold  every  one  of  those  fine  fibers  taut — 
those  nerves,  built  in  and  tuned  to  the  large  noises  and 


117 

great  silences  of  the  plains  and  forests  and  the  slow  cinema 
of  the  stars  at  night.  The  child  in  a  trip  down  town  uses 
more  nervous  energy  than  primitive  man  needed  in  a 
lifetime. 

Is  it  any  wonder  that  the  harassed  teacher  fails  to 
achieve  any  large  measure  of  success  in  arbitrating  between 
the  irresistible  and  the  immovable?  Is  it  any  wonder  that 
thousands  of  teachers  are  themselves  being  sacrificed  to  the 
actually  heroic  effort  they  are  making  to  hold  apart  with  the 
strength  of  their  own  nerves  the  two  mill-stones? 

The  essential  health  habits  are  instinctive.  Modern  in- 
stitutions, so  far  as  the  child  is  concerned,  are  more  plastic 
than  these  instinctive  reactions.  So  the  first  step,  without 
which  there  is  no  use  at  all  in  attempting  Health  Education, 
is  to  supply  him  while  growing  with  the  modern  equivalent 
of  the  ancient  conditions  under  which  these  reactions  were 
built  into  his  cells.  This  is  neither  so  large  an  order  nor  so 
difficult  of  fulfillment  as  it  sounds.  The  very  fact  that  the 
race  is  biologically  at  the  age  it  was  before  the  dawn  of  all 
these  complexities  of  modern  life,  gives  the  baby  a  fresh 
start,  back  at  the  tape.  The  very  fact  that  the  real  essen- 
tials of  health  are  instinctive  makes  them  simple  and  easy 
of  attainment,  once  the  home  is  actually  convinced  of  their 
necessity. 

It  is  the  contrast  between  the  importance  of  their  effects 
and  the  simplicity  and  relative  ease  of  attainment  that  is  the 
difficulty.  If  Health  Pills  were  obtainable,  at  say  a  thousand 
dollars  a  pill,  there  is  not  a  parent  but  would  by  some  hook 
or  crook  manage  to  buy  one  for  each  child.  No  length  of 
personal  sacrifice  would  be  extreme.  But  to  believe  that 
putting  the  child  to  bed  early  every  night,  and  giving  him 
certain  simple  foods,  and  letting  him  alone  for  the  rest  will 
achieve  the  same  end — is  too  much.  He  must  have  the 
"good"  things  of  life,  and  the  "advantages"  of  which  they 
themselves  were  deprived. 

If  we  can  only  manage  to  get  one  crop  of  well-fed  Remaking 
adolescent  girls,  with  calcium  and  phosphorus  in  their  bony  ^Tw™ 
structure ;  teach  them  the  few  essentials  of  efficient  mother-  Genera- 
hood,  to  live  simply  and  nurse  their  babies,  the  trick  is  * 
turned.    The  maddening  thing  about  it  all  is  the  difficulty 
of  making  parents  and  school  officials  see  the  picture  in  our 
own  minds;  the  cosmic  importance  of  the  result,  the  utter 
simplicity  and  ease  of  attainment.    Why,  we  could  remake 


118 

the  race  in  two  generations  if  we  could  only  shake  parents 
and  teachers  into  the  realization  of  their  responsibility  and 
privilege. 

It  is,  after  all,  a  moral  problem.  It  will  have  to  be  dealt 
with  through  the  emotions.  Never  have  I  so  longed  for  the 
gift  of  eloquence — to  shake  hell  fire  and  damnation  in  the 
face  of  the  present  generation  of  adults  to  make  them  give 
us  educable  material  at  six,  and  build  about  the  child  sur- 
roundings that  will  permit  him  to  live  a  simple  life  during 
the  early  plastic  years.  By  the  time  he  reaches  the  age 
when  he  can  determine  his  own  environment,  his  cells  have 
pretty  well  learned  their  life  habits.  The  only  thing  then 
left  us  is  to  capitalize  that  wonderful  flowering  time  of 
adolescence  and  teach  boys  and  girls  their  responsibility  to 
the  next  generation.  Those  who  have  worked  sympatheti- 
cally with  High  School  pupils  know  the  amazing  sensitive- 
ness beneath  the  rouge  of  the  "flappingest"  flapper  and  the 
swagger  of  the  "sportingest  Seventeen."  It  is  as  if  Nature 
in  disgust  at  our  stupidity  tossed  us  yet  another  chance  at 
the  problem,  so  plain  as  to  be  fool-proof  and  yet  we  miss  it. 

I  should  not  write  a  paper  in  my  present  frame  of  mind. 
I  resemble  nothing  so  much  as  the  twins'  fox  terrier  when 
he  starts  down  to  China  after  the  rodent  which  may  or  may 
not  be  there.  I  succeed  only  in  filling  the  eyes  of  those 
about  me  with  dust.  If  I  unearth,  beneath  the  aforesaid 
bank  of  figures  and  traits  and  averages  into  which  I  am  at 
present  engaged  in  burrowing,  one  single  bone,  I  will  lay  it 
before  you  at  our  next  Conference,  and  ask  you  to  help  me 
reconstruct  the  animal. 

Let  me  repeat  that  which  I  said  in  the  beginning  and 
which  the  subsequent  pages  may  have  seemed  to  belie.  In 
spite  of  my  sense  of  having  come  upon  a  blind  alley  I  have 
never  been  so  far  from  discouragement  as  at  the  present 
moment.  True,  we  can  never  return  to  the  days  of  instinc- 
tive behavior — the  toad  hath  spoken  to  the  centipede — and 
reasoned  adjustment  must  take  the  place  of  the  insouciance 
of  the  myriapod  in  question,  before  its  segments  had  become 
so  numerous  as  to  cause  embarrassment. 

But,  perhaps  Professor  Lankaster's  toad,  like  Shakes- 
peare's, bears  yet  the  precious  jewel.  The  struggle  of  the 
centipede  to  coordinate  the  ineffectual  appendages  is  re- 
warded by  the  slow  slipping  forward  and  concentrating  of 


119 

ganglia.     He   is   on   his   way   toward  organized   conduct. 
Here's  hoping. 

Discussion 


The  discussion  was  opened  by  Miss  Margaret  Sparks, 
Nutrition  Specialist,  Public  Schools,  Trenton,  N.  J.,  who 
told  something  of  the  Trenton  program  during  the  last  two 
years.  She  said  that  the  local  chapter  of  the  American  Red 
Cross  had  placed  at  the  disposal  of  Dr.  Wilkes  $10,000  with 
which  to  carry  on  this  demonstration. 

It  was  the  effort  to  have  the  two  hundred  students  of 
the  academic  division  of  the  ninth  grade  civic  classes  really 
appreciate  what  Trenton  is  doing  to  safeguard  the  health 
of  its  citizens  and  especially  the  importance  and  necessity 
for  such  protection, — that  was  responsible  for  the  health 
project  of  Junior  School  Number  Two  of  Trenton,  New 
Jersey. 

The    students   were   very   much   impressed    with   the  ^ 
solemnity  of  the  obligations  laid  upon  them,  especially  when  Sc 
they  learned  that  all  data  relative  to  the  experiment  would  p 
be  filed  in  the  office  of  the  school  doctor.    This  was  the  sole 
incentive  given  the  experimenters,  and  the  hope  of  being  of 
service  to  others,  of  making  a  real  contribution  to  the  health 
knowledge  of  the  world  proved  more  potent  than  any  hope 
of  mere  personal  reward.    In  fact  it  was  the  key  to  the  un- 
expected enthusiasm  of  the  project.     Each  child  promised 
faithfully  to  make  it  a  real,  scientific  experiment. 

At  the  outset  several  very  difficult  questions  presented 
themselves : 

1.  Could  such  an  extensive  project  be  included  in  an  already 
overcrowded  civics  course  of  study? 

2.  Could  enthusiasm  be  inspired  in  view  of  the  fact  that  no 
supplies  would  be  available  other  than  those  the  children  should 
make  for  themselves? 

3.  Could  interest  be  maintained  among  boys  and  girls  over 
such  a  long  period  of  time  especially  when  no  reward  was  offered? 

4.  Would  High   School  boys  and  girls  enjoy  an  experiment 
of  this   sort   or  would   they  feel   that  they  had   exhausted   the 
possibilities   of  the   subject   in   the   lower   grades? 

As  is  usually  the  case,  the  challenge  of  the  difficult 
served  only  to  inspire,  not  to  discourage. 

The  first  necessity  was  obviously  to  select  the  health 
rules  on  which  the  experiment  would  be  based.  At  first  a  list 


120 

of  twenty  rules,  any  ten  of  which  might  be  obeyed,  was 
placed  on  the  blackboard.  This  soon  proved  unsatisfactory. 
The  girls  of  the  third  division  objected  on  the  ground  of  a 
lack  of  uniformity.  They  decided  to  select  the  ten  which  in 
their  judgment  were  most  vital.  Each  girl  handed  in  a 
list  of  the  ten  rules  which  she  thought  most  essential.  From 
these  lists  a  committee  of  three  selected  the  ten  that  would 
be  used  by  the  class.  The  very  day  the  revised  list  was 
adopted  the  class  received  a  suggestive  list  from  the  Health 
Education  Department.  As  this  was  practically  the  same 
as  that  of  the  class,  the  latter  asked  for  and  obtained  a 
mimeographed  copy  of  these  rules  for  every  student  in  the 
academic  division  of  the  ninth  grade. 
The  list  read  as  follows: 

lr  Sleep  eight  hours  every  night  with  windows  open. 

2.  Brush  teeth  properly  for  three  minutes  after  meals  and 
at  bed-time.     Wash  hands  before  each  meal. 

3.  Cultivate  the  habit  of  keeping  fingers  and  pencils  out  of 
the  mouth.     Keep  finger  nails  clean. 

4.  Take  ten  or  twelve  deep  breaths  of  fresh  air  every  morn- 
ing and  follow  this  with  hygienic  exercises  for  three  minutes. 

5.  Regular  toilet  habits. 

6.  Avoid  undue  exposure — always  wear  sufficient  warm,  loose, 
soft  clothing. 

7.  Eat   regularly   three   times   a    day — always    include   fruit 
and  vegetables. 

8.  Eat  sweet  foods  only  at  the  end  of  a  meal. 

9.  Drink  milk  or  cocoa,  but  no  coffee  or  tea. 

10.  Nourishing  foods  can  always  be  made  palatable  and  at- 
tractive in  appearance.     Avoid  fads  and  self-analysis. 

Most  of  the  boys  and  girls  kept  this  list  in  their  note- 
books. Some  tacked  them  in  the  bath-room,  some  in  their 
bedrooms  and  one  over  the  kitchen  sink. 

The  rules  having  been  determined,  each  pupil  received 
a  health  chart.  On  this,  from  cards  given  out  by  the  Child 
Health  Organization,  each  determined  the  gain  he  or  she 
might  normally  be  expected  to  make  in  a  month.  This  was 
Organi-  carefully  plotted  on  the  chart  in  a  dotted  line  along  which 
zaiion.  was  printed  "normal  gain."  The  weight  tables  of  the  Child 
Health  Organization  were  then  posted  on  the  bulletin  board 
and  were  frequently  consulted  by  the  children  in  their  free 
periods.  Each  month  the  students  were  weighed  and  the 
result  plotted  in  a  heavy  line  on  the  individual  weight 
charts.  From  the  first  on  intense  interest  in  and  rivalry 


121 

over  weights  obtained,  and  this  was  maintained  until  the 
very  last  hour  of  the  experiment.  The  students  were 
greatly  elated  as  their  weight  line  increased  and  very  much 
disappointed  when  for  any  reason  it  fell  below  the  dotted 
line.  Frequently  children  asked,  "What  can  I  do  to  gain 
weight?"  The  teacher  used  this  opportunity  to  stress  proper 
nutrition. 

Every  month  as  the  weight  was  plotted,  each  student 
was  handed  a  card  on  which  he  wrote  his  special  health 
efforts  for  the  month  and  especially  the  reasons  why  he 
believed  his  line  rose  so  far  above  or  fell  below  the  normal. 
These  cards  were  very  instructive.  One  girl's  graph  as  a 
result  of  her  ardent  efforts  showed  a  gain  of  five  pounds 
over  her  entrance  weight.  She  was  inordinately  proud  of 
her  record.  Suddenly  she  developed  the  measles  and  at  the 
next  weighing  fell  three  pounds  below  her  entrance  weight. 
Her  disgust  was  amusing. 

The  relationship  between  sickness  and  loss  of  weight 
was  startling  to  the  children. 

Every  day  some  little  encouragement  was  given  the  ex- 
perimenters. One  fact  that  was  constantly  impressed  upon 
the  children  was  that  unless  their  statements  expressed  the 
real  truth  they  would  not  be  at  all  valuable. 

Two  health  officers  were  appointed  in  each  class,  one 
to  care  for  the  graphic  weight  charts  and  one  for  the  record 
cards.  In  addition  a  student  was  appointed  to  care  for  a 
health  habit  practice  record.  Those  who  observed  eight 
rules  received  a  mark  of  eighty,  those  who  observed  nine 
rules  a  mark  of  ninety,  etc.  At  the  end  of  the  montti,  the 
marks  were  added  to  see  which  individual  in  a  given  group 
should  have  the  highest  mark  and  which  of  the  six  groups 
should  excel  the  others.  To  stimulate  interest  between 
markings  various  interesting  articles  were  read;  e.  g., 
Mary  Pickford  on  "high-heeled  shoes,"  and  "The  Diary  of  a 
Stomach."  In  addition,  special  reports  were  given  on 
various  health  topics. 

The  children  asked  so  many  questions  that  it  was 
finally  found  necessary  to  make  a  "question  box."  A  boy 
from  the  first  division  took  special  pride  in  making  it  as 
attractive  as  possible.  This  box  was  nailed  in  a  corner  of 
the  room.  It  was  to  contain  questions  only  on  health 
preservation.  Once  a  month  the  questions  were  taken  from 
it  and  sent  to  the  administration  building,  where  they  were 


122 


Weight 
Gains. 


answered  by  Dr.  Wilkes,  Miss  Sparks,  or  Dr.  Edwards,  the 
school  dentist.  The  children  thoroughly  enjoyed  these  ques- 
tions and  answers.  Once  when  the  teacher  forgot  to  read 
them  to  the  class  she  was  rather  vociferously  reminded 
of  it. 

So  many  questions  were  asked  about  yeast  and  vita- 
mines  that  the  children  were  furnished  with  charts  on 
which  the  function  of  each  of  the  three  classes  of  vitamines 
was  set  forth  as  well  as  foods  containing  each.  Some  idea 
of  the  amount  of  vitamines  in  each  food  was  also  included. 

In  March  the  nutrition  expert  made  a  special  study  of 
the  weight  charts.  These  showed  an  average  gain  of  140 
per  cent.  They  also  showed  that  the  malnourished  students 
had  decreased  from  16.4  per  cent,  to  9.2  per  cent.  Moreover 
the  students  of  normal  weight  had  increased  from  57.5  per 
cent,  to  77.1  per  cent.  The  fourteen  students  who  were 
found  to  be  malnourished  were  given  special  literature  on 
proper  nutrition.  The  Medical  Director  and  his  assistants 
also  came  to  the  school  and  gave  each  a  special  examination, 
clinching  it  with  advice  peculiarly  applicable  to  the  case 
under  observation. 

With  the  coming  of  Spring  weather,  and  the  consequent 
increase  of  outdoor  activity,  there  was  a  decided  falling  off 
in  weight.  However,  strange  to  say,  there  was  no  diminu- 
tion of  interest  in  the  experiment.  Many  expressed  regret 
that  it  concluded  in  May  instead  of  June. 

At  the  close  of  the  experiment,  each  student  wrote  a 
letter  to  the  teacher  telling^what  the  experiment  meant  to 
him.  The  following  are  typical  of  the  letters  received. 

A  careful  analyses  of  the  letters  revealed  the  following 
facts : 


Other 

Health 

Gains 

Illustrated 

by 

Children's 

Letters. 


Ten  children  ate  breakfast  who  had  never  eaten  it  before. 
The  following  exceptions  are  characteristic:  "I  eat  some  breakfast 
now  although  I  hate  to  do  so,  but  mother  doesn't  have  to  make 
me  do  it  now." 

Nineteen  got  more  sleep,  indeed  one  boy  finds  it  "difficult  to  do 
without  eight  hours  of  sleep  now." 

Twelve  ate  more  green  leafy  vegetables. 

Five  practised  taking  deep  breaths  every  day. 

Eight  students  who  never  did  so  before  now  wash  their 
hands  before  meals.  One  boy  says,  "Now  that  I  am  obeying 


123 


the  health  rules  I  can't  sit  by  the  table  and  eat  before  I  wash 
my  hands." 

Twenty  exercised  more. 

Eleven  ate  more  cereal. 

Eight  said  the  health  rules  had  become  such  habits  with  them 
that  they  could  not  break  them. 

Sixty-one  brushed  their  teeth  more  regularly.  One  little  girl 
was  well  pleased  because  "Mother  never  tells  me  to  clean  my  teeth 
now." 

Forty-six  drank  more  milk. 

Thirty-two  stopped  using  coffee. 

Eighteen  drank  less  coffee  than  formerly. 

Twenty  stopped  using  tea. 

Five  used  less  tea  than  formerly. 

Thirteen  said  "they  had  had  no  headaches  since  the  experiment 
started"  No  statement  in  all  the  letters  was  more  interesting 
than  this  or  more  unexpected  as  the  school  is  a  one-session  school 
and  lasts  from  quarter  of  nine  until  three-thirty  with  only  a 
half-hour  lunch  period. 

Eleven  gave  up  eating  candy  between  meals,  eating  it  only 
with  meals. 

Twenty-eight  ate  more  fruit.  One  girl  wrote,  "I  never  ate 
fruit  before." 

Thirty-two  ate  more  green  vegetables. 

Thirty  opened  their  windows  at  night  although  they  had 
never  done  it  before.  One  boy  said,  "Before  the  health  experi- 
ment, I  slept  with  my  windows  open  when  mother  opened  them, 
but  now  I  open  them  myself." 

Eight  tried  to  keep  pencils  out  of  their  mouths  although 
many  confessed  that  they  didn't  succeed  very  well. 

Seven  tried  to  stop  biting  their  nails.  One  of  the  girls  suc- 
ceeded in  growing  nails  long  enough  for  her  cousin  to  manicure 
for  her.  She  and  a  friend  are  now  having  a  race  to  see  who 
shall  have  the  prettier  nails. 

Two  "couldn't"  stop  biting  their  nails. 

Four  gave  up  eating  between  meals. 

One  girl  who  never  brought  lunch  to  school  brought  it  as  a 
result  of  the  experiment. 

One  drank  more  water. 

Three  had  more  headaches. 

One  found  the  experiment  uninteresting  after  the  second 
month. 

One  group  was  greatly  stimulated  to  action  when  one  of 
the  girls  reported  that  the  Rotary  Club  to  which  her  father 
belonged  was  checking  up  on  the  same  health  rules  as  those 
given  to  the  school  children. 

It  was  most  satisfactory  to  see  what  an  interest  the  mothers 
took  in  the  experiment.  Many  students  said  their  mothers  saw 
that  they  obeyed  the  health  rules. 


124 


Conclu- 
sions. 


Trenton 

Health 

Program. 


The  following  tabulations  are  the  final  results  obtained : 

Sex  Expected  Gain  Actual   Gain 

Boys  and   Girls  167%  195 

Boys   and   Girls  196  &  246  % 

Girls  110%  119 

Boys  247%  266 

Girls  81%  87 

Boys  246%  222* 


1050  1135 % 

Percentage  of  gain  for  entire  class,  100  per  cent. 

The  conclusions  drawn  from  the  experiment  were: 

1.  That  there  is  a  direct  relationship  between  failure  to  gain 
and   sickness.     Vice   versa   there   is   also    a   direct   relationship 
between  a  steady  gain  and  good  health. 

2.  That  the  subject  of  health  per  se  is  interesting  to  boys  and 
girls. 

3.  That  the  thought  of  serving  others  is  a  more  interesting 
reward  to  boys  and  girls  than  any  prize. 

4.  That  children  like  a  visible  demonstration  of  what  they 
have  accomplished,  hence  the  value  of  the  graphs. 

5.  That  children  will  themselves  assume  responsibility  for  a 
gain  in  weight  and  will  carry  the  inspiration  for  good  health 
practices  into  the  homes. 

6.  That  in  the  majority  of  instances  those  who  obeyed  the 
rules  most  consistently  showed  the  greatest  gains. 

7.  That  the  actual  gain  or  loss  in  pounds  was  a  very  small 
part  of  the  class  accomplishments  for 

a.  Positive  health  rules  were  formed. 

b.  A  vital  interest  in  health  was  created. 

c.  Each  individual  through  experience  knew  what  healthy 
citizens  can  mean  to  a  community,  and 

d.  Best  of  all,  through  actually  living  out  the  health  rules, 
each  student  knew  how  to  approach,  attain  and  ultimately  (in 
the  majority  of  cases),  maintain,  that  ideal  state  of  being  a 
healthy  and  therefore  a  happy  citizen. 

Dr.  Wilkes,  upon  being  asked  to  describe  the  Health 
Program  of  the  Trenton  Public  Schools,  presented  the  fol- 
lowing outline: 

I.     Observation  and  Detection. 


a.  Daily  observation  and  study  of  children  by  teachers  to 
determine  "normal"  appearance  of  individual  children,  in  order 
to  be  able  to  detect  the  earliest  signs  of  departure  therefrom. 
Any  pupil  appearing  other  than  "normal"  shall  be  isolated  and 
referred  to  doctor  or  nurse  as  soon  as  possible. 


*These  boys  are  ardent  baseball  fans.     Their  record  was  considerably  over  100  per 
cent,  before  the  season  opened. 


125 


b.  Routine  physical   examination  of  every  pupil  yearly — in- 
cluding dental  examination. 

c.  Subsequent  inspections  and  re-examination  of  pupils  found 
defective. 

d.  Follow-up  by  nurses  on  defectives  by  home  visits. 

II.     Corrective  Measures 


Correlated  action  in  corrective  measures  by  school  medical, 
dental  and  physical  departments,  family  physicians,  dentists;  to- 
gether with  parents,  teachers  and  school  nurses,  to  return  defec- 
tives to,  insofar  as  possible,  normal  at  the  earliest  possible 
moment. 

III.    Preventive  Measures. 


For  health  preservation,  especially  of  sight,  hearing, 
posture,  teeth,  etc. 

a.  Educational  for  Child. 

1.  Correlation  of  health  with  all  educational  subjects,  es- 
pecially in  elementary  grades. 

2.  Talks   upon   request,   by    Medical    Director,    Inspectors, 
dentist,  or  nurses. 

3.  Literature,  charts,  graphs,  posters,  health  rules,  slides 
and  films,  games,  plays,  "snapshots"  of  best  specimens,  etc. 

4.  Individual  examination   and  advice  in  consultation  by 
director. 

b.  Educational  for  Parents  and  Others. 

1.  Personal  message  carried  directly  to  parents  at  Parent- 
Teachers  meetings  by  means  of  illustrated  talks,  demonstra- 
tions, etc.,  by  members   of   Health   Supervision   Department, 
slides,  and  charts,  etc.,  chiefly  by  Medical  Director  and  Health 
Educator.    Personality  is  as  important  as  the  message. 

2.  Personal  contact  with  parents  in  homes  on  individual 
problems,  by  nurses  and  teachers  making  "home  visits." 

3.  Literature  distributed  to  parents  through  children. 

4.  Newspapers,    organizations,    etc.,    used   for   educational 
propaganda. 

IV.  Control  of  Contagion. 

"Smother  coughs  and  sneezes"  and  isolate  all  children  de- 
parting from  "normal"  in  appearance  from  the  others  until 
seen  by  the  doctor.  Send  home  on  doctor's  advice  or  that  of  the 
nurse  or  teacher. 

V.  Intensive  care  of  special  groups  by  measures  in- 
tended for  their  care  and  restoration.   For  malnourished, 

crippled,  anemic  and  tubercular  contacts,  blind,  deaf, 
epileptic,  cardiac,  speech  defects,  mentally  subnormals 


126 

— where  sufficient  are  found,  special  classes  are  formed 
where  the  work  and  number  of  pupils  is  restricted. 

a.  Malnourished — rest    or    modified    exercise    in    gymnasium 
periods,  and  milk  in  milk  periods. 

b.  Anemic  and  Tubercular  Contacts — Open  Air  School. 

c.  Cripples — Transportation  to  be  provided  and  special  desks 
to  fit  deformities. 

d.  Blind  and  Deaf — State  provides  care. 

e.  Mentally  Deficient — Special  classes  provided. 

f.  Cardiac — Avoidance   of   stairs   and   gymnasium   when   ad- 
visable. 

g.  Speech  defects — Survey  and  plan  outlined,  but  no  provision 
made  as  yet. 

VI.  Athletic  Competition. 

When  the  following  things  are  done  parents  then  feel 
that  every  precaution  has  been  taken: 

a.  All  school  children  engaging  in  competition  shall  be  exam- 
ined and  supervised  by  the  school  physicians. 

b.  Examination  by  physician  of  injuries  occurring  on  school 
property    (when  possible)    before   child  leaves  the  building   or 
field. 

c.  Medical  examinations  and  advice  to  coaches  upon  request. 

VII.  Dental  Work. 


a.  Survey  of  all  pupils  and  charting  of  findings. 

b.  Repair  6th  year  molars  of  indigent  children. 

c.  Repair  teeth  of  children  of  indigent  parents  when  they 
want  to  go  to  work.     (They  must  pass  physical  requirements.) 

VIII.    Research. 


Correlation  of  physical  and  dental  defects  with  attendance, 
nutrition,  contagion,  mentality,  vitality,  etc. 

Routine  Dr.  Bigelow  here  raised  the  question  as  to  whether  there 

tion  PrT"  *s  dan£er  that  this  routine  examining  of  children  and  mak- 

duce  Un-  ing  them  conscious  of  their  condition,  will  have  the  effect  of 

Itntro^  creating  the  most  introspective,  hypochondriacal  group  of 

spection?  young  people  the  world  has  ever  known. 

Miss  Bragg  replied : 

"I  may  be  prejudiced  but  our  children  in  Newton  are  very  happy 
in  this  work.  The  teachers  must  be  wise.  The  children  who  have 
become  self-conscious  have  to  be  dealt  with  as  individuals  from  the 
point  of  view  of  the  right  kind  of  treatment.  It  is  only  the  stupid 
teachers  who  make  children  unhappy." 

Dr.  Wood  added: 

"I  am  in  sympathy  with  Dr.  Bigelow's  inquiry  as  to  the  results 
20  years  hence,  but  I  think  that  all  these  honest,  well-intentioned, 


127 

most  serious  experiments  that  we  can  try,  are  worth  trying.  There 
may  be  danger  in  them.  We  learn  more  sometimes  from  failures 
than  from  successes,  but  we  must  remember  for  the  sake  of  our 
associates  who  help  us  in  our  work,  the  tremendous  significance  of 
the  consciousness  of  success,  partial  or  comparative,  the  success  de- 
pendent upon  continuous,  honest  effort." 

Dr.  Bigelow  stated  that  he  had  no  fear  for  the  normal  or 
super-normal,  only  for  the  subnormal  ones  who  are  not  suc- 
ceeding. 

Professor  Turner  added,  going' back  to  Dr.  Bigelow's 
question : 

"Apropos  of  this  matter  of  worrying  children  and  how  we  are 
going  to  get  this  thing  across,  I  would  say  that  I  got  a  great  deal 
of  satisfaction  from  the  teacher  who  said  that  everybody  could  not 
be  equally  robust,  and  that  Mr.  Darwin  and  Mr.  Stevenson  had  suc- 
ceeded in  doing  a  good  deal  for  the  world,  although  they  could  never 
be  quite  as  robust  as  some  of  the  famous  athletes  in  history.  You 
have  seen  men  come  into  college  from  high  school  with  ability  to 
make  an  athletic  team  in  the  institution  and,  because  they  broke 
training  they  were  kicked  out  of  athletics  before  the  junior  year. 
And  then  some  man  with  a  poor  physique  comes  in  and  by  a  long 
and  fine  course  of  training  builds  himself  up  to  a  position  of  national 
championship.  I  believe  it  is  possible  to  handle  underweight  children, 
when  we  use  that  project,  without  making  them  tremendously  dis- 
couraged. 

"There  are  two  or  three  things  we  are  moving  towards  in  our 
methods  of  getting  across  to  the  children  the  things  that  we  want.  One 
thing  is  that  we  are  talking  about  health  for  the  whole  school  group 
and  are  not  any  longer  in  many  places  giving  aid  to  a  particular  group 
of  malnourished  children  until  we  get  them  up  to  normal  weight,  and 
then  letting  them  go. 

"We  are  coming  to  believe  less  and  less  in  rewards  and  competi- 
tion and  records,  or  a  combination  of  records  and  rewards  as  incen- 
tives and  motives  and  to  believe  more  and  more  in  what  Miss  Bragg 
phrased  as  'the  Power  of  an  Idea.'  People  are  enthusiastic  for  health. 
I  don't  know  what  a  boy  won't  do  to  get  into  athletic  condition, 
and  from  what  I  read  in  the  newspapers  about  the  beauty  parlors 
I  do  not  know  what  a  girl  won't  do  to  be  beautiful.  I  am  wondering 
whether  we  need  special  competitions.  In  Maiden  we  have  used 
weight  records  through  the  year,  and  I  think  we  have  used  them  with- 
out assuming  that  the  weight  record  was  a  physical  diagnosis.  I 
do  believe  that  we  must  be  careful  in  the  use  of  our  weights.  I 
*,hink  that  none  of  us  must  ever  promote  children  from  underweight 
to  a  normal  group  except  on  basis  of  height  at  the  time  he  is  weighed. 
If  anyone  here  who  has  used  both  methods  can  tell  us  by  actual 
experience  that  a  reward  can  produce  the  result  which  the  power 
of  an  idea  cannot  produce  I  would  like  to  know  about  it." 


128 


Give  All 

Children 
the  Advan- 
tages Now 
Enjoyed 
Only  by  the 
Handi- 
capped. 


Miss  Mary  Murphy,  Elizabeth  McCormick  Memorial 
Fund,  Chicago,  111.,  said: 

"We  have  been  interested,  as  many  of  you  know,  in  two  branches, 
in  two  school  systems — one  under  Miss  Brown  (whose  paper  has 
just  been  given  this  afternoon)  in  Oak  Park,  Illinois,  which  is  close  to 
the  city  of  Chicago,  and  really  an  American  community,  and  another 
in  a  town  of  6,000,  about  40  miles  from  Chicago,  where  there  are 
large  industries  and  a  large  foreign  population. 

"We  have  had  a  very  interesting  reaction  from  many  teachers. 
When  the  pupils  were  presented  at  the  outset,  the  difference  in  poor 
health  and  malnutrition  represented  in  the  schools  was  thought  to  be 
a  matter  of  ages,  or  a  matter  of  grades  or  a  matter  of  race.  A 
classification  was  later  made  by  grades,  showing  that  no  such  thing 
could  account  for  this.  Each  teacher  set  to  work  at  her  own  problem. 
The  interest  and  the  health  standard  of  each  teacher  was  indicated 
by  the  progress  made  throughout  the  year.  We  feel  that  the  per- 
sonality and  standard  of  health  which  each  teacher  has,  is  responsible 
for  a  large  percentage  of  the  progress  that  her  pupils  make  in  the 
grades.  One  other  little  angle  I  wish  to  mention.  We  were  first  in- 
terested in  this  problem  of  health  teaching  through  the  work  in  the 
open-air  school.  Part  of  our  work  has  been  promoting  such  schools. 
We  soon  came  to  realize  by  talking  with  people  who  worked  with  the 
subnormal  and  delinquent  schools  that  what  we  were  advocating 
for  a  select  group  were  principles  which  should  be  applied  to  the 
entire  school  system.  From  the  work  that  has  been  done  in  open-air 
schools  with  fewer  children  to  a  teacher  it  is  evident  that  for  best  re- 
sults we  must  have  comparable  conditions  in  all  rooms,  and  advocate 
25  to  30  children — not  more,  to  a  teacher.  Let  food  be  made  available 
at  least,  if  not  actually  served  to  children.  Those  principles,  if  good 
for  the  selective  group,  are  just  as  good  for  the  large  group,  and 
should  be  in  the  same  school  system  where  we  will  find  these  things 
for  the  selective  group. 

"And  while  we  are  considering  Health  Education  I  wish  we  might 
do  more,  as  Miss  Bragg  and  Professor  Turner  suggested,  with  the 
power  of  an  idea,  in  making  the  school  itself  as  well  as  the  homes, 
through  construction,  administration  and  organization,  contribute  to 
health,  while  we  are  giving  Health  Education." 

Regarding  successful  ways  of  forming  health  habits, 
Dr.  Kleinschmidt  said : 

"We  are  in  need  of  teaching  health  principles.  I  cannot  quite  be- 
lieve that  the  only  way  to  teach  the  child  is  through  habits,  and  I 
heartily  commend  the  idea  that  we  can  dig  out  plans  and  methods 
whereby  we  can  carry  over  fundamental  principles  and  ideas  so  that 
the  child  will  form  its  own  opinions  and  know  principles  of  action." 

The  chairman  closed  this  discussion  by  the  statement 
that  workers  in  Health  Education  particularly  have  a  very 
keen  appreciation  of  the  importance  of  all  that  psychology 
can  teach  in  its  application  to  this  field,  and  such  help  is  of 


129 

vast  importance.  He  then  introduced  Miss  Ethel  Perrin, 
Assistant  Director  of  Health  Education,  Detroit  Public 
Schools,  Detroit,  Michigan,  to  discuss  further  "Successes 
and  Failures  in  Promoting  Health  Habits/' 

Before  starting  the  discussion  of  her  subject  Miss  Per- 
rin described  conditions  in  Detroit,  saying : 

"We  have  had  a  very  wonderful  opportunity  in  our  new  Junior 
High  School  or  Intermediate  School,  and  I  am  going  to  give  you  a 
report  of  it.  Our  first  new  building  to  be  run  under  the  new  schedule 
was  opened  in  February.  There  are  1500  children  in  that  school,  and 
they  all  pass  through  the  Health  Education  Department.  All  those 
children  pass  through  our  hands  for  60  minutes  every  day  for  3  years. 
This  means  that  our  plant  is  well  equipped.  We  have  every  oppor- 
tunity there, — 2  gymnasiums, — 2  rooms  for  health  instruction, — 2 
play  courts, — 2  playgrounds, — everything  that  we  could  possibly 
desire.  We  have  9  teachers,  but  want  10.  We  have  5  women  and  4 
men.  About  150  girls  come  into  the  gymnasium  for  60  minutes  every 
day.  They  are  divided  into  groups.  The  examinations  are  made 
through  City  Department  of  Health  in  conjunction  with  our  people. 
Some  go  into  the  gymnasium  and  some  to  the  playground.  One  group 
always  goes  into  health  instruction  class.  This  is  our  setting  in  the 
new  school." 

She  then  proceeded  to  give  a  statement  of  recent  De- 
troit experiences  in  Health  Education: 

Failures  and  Successes  in  the  Promotion  of  Health  Habits 

Miss  Perrin: 

THE  Department  of  Health  Education  in  the  City  of  De- 
troit has  gone  through  the  usual  stages  of  development, 
starting  with  Physical  Culture  and  the  sort  of  work  for 
which  that  name  stands.  When  I  took  charge  of  it  some 
ten  years  ago  we  changed  its  name  to  Physical  Training, 
and  placed  its  responsibility  largely  in  the  hands  of  the 
classroom  teachers  for  this  special  subject.  As  we  pro- 
gressed to  teachers  who  gave  their  undivided  time,  we 
changed  our  name  to  Physical  Education,  and  when,  a  few 
years  ago,  through  the  stimulation  of  the  Jean  who  put 
gene  in  genius,  we  awoke  to  our  full  responsibilities,  we 
adopted  the  name  of  Health  Education. 

We    consider    our    responsibilities    to    be    seven-fold,  Seven-fold 
namely: 

1.  Development  of  a  perfect  physical  body. 

2.  Teaching  worthy  use  of  leisure  time. 

3.  Contributing  to  command  of  fundamental  processes. 


130 

4.  Contributing  to  worthy  home  membership. 

5.  Contributing  to  vocational  ability. 

6.  Contributing  to  civic  objectives. 

7.  Contributing  to  ethical  character. 

We  believe  that  the  foundation  upon  which  to  build  is : 

1.  Control  of  growth. 

2.  Control  of  physical  ability. 

3.  Control  of  illness. 

4.  Control  of  defects. 

5.  Control  of  accidents. 

6.  Control  of  energy  and  vitality. 

We  also  believe  that  we  can  only  reach  control  of  these 
last  six  major  problems,  through  the  study  of  their  nine 
contributing  factors: 

1.  Food. 

2.  Rest. 

3.  Air. 

4.  Exercise. 

5.  Clothing. 

6.  Cleanliness. 

7.  Posture. 

8.  Leisure  time. 

9.  State  of  mind. 

The  activity  side  of  our  program  consists  largely  of 
games,  athletic  sports,  dancing  and  self -testing  activities, 
all  of  which  are  taken  care  of  by  supervisors  and  teachers 
trained  for  this  purpose. 

My  talk  today  will  only  touch  upon  the  side  of  the  work 
we  call  Health  Instruction,  and  I  shall  give  you  our  ex- 
periences for  the  past  three  years. 

The  Modern  Health  Crusade  was  our  first  venture,  and 
in  ^Health  it  gave  us  an  excellent  start.  Through  the  cooperation  of 
Education,  the  Detroit  Tuberculosis  Society  we  were  able  to  distribute 
the  literature  and  buttons  for  this  work  free  of  charge  to 
the  Board  of  Education  to  every  teacher  who  wished  to 
carry  on  the  Crusade.  Thousands  of  children  became  in- 
terested and  the  communit|r  was  awakened  to  the  value  of 
health  habit  training.  Weround  that  the  interest  died 
down  because  the  work  was  ungraded  and  the  children  did 
not  enjoy  repeating  it  term  after  term.  So  we  set  about 
forming  health  clubs  patterned  largely  after  the  Rochester 
Plan.  One  assistant  supervisor  gave  her  full  time  to  grad- 
ing these  clubs  from  the  first  through  the  eighth  grades. 
We  then  proceeded  along  approved  experimental  lines  and 


131 

tried  these  clubs  out  in  schools  selected  by  the  school  au- 
thorities for  all  experimental  work,  thus  putting  our  best 
teachers  into  it.  They  made  a  great  success  of  it  as  far  as 
we  could  see  at  first  (which  was  not  so  very  far),  and  we 
were  immensely  pleased.  One  day  when  I  proudly  took  a 
visitor  around,  the  question  of  open  windows  at  night  was 
being  recorded,  row  by  row.  One  little  boy  was  looking 
sadder  and  sadder  while  the  other  children  of  his  row  were 
looking  madder  and  madder  because,  as  usual,  they  were 
not  making  a  perfect  score  on  the  window  proposition.  I 
waited  my  chance  to  speak  to  him  by  himself  and  asked 
why  he  did  not  open  his  window.  He  looked  at  me  rather 
pitifully  and  said  because  he  had  no  window  in  his  room. 
We  straightened  this  particular  case  by  voting  that  in  such 
a  case  the  opening  of  a  door  into  a  room  where  a  window 
was  open  should  score  a  point  and  all  was  well.  This  was 
an  eye-opener  into  the  objections  to  this  method  of  teaching 
health  habits  when  adhered  to  too  rigidly  and  without  a 
thorough  understanding  of  the  home  conditions  of  the  chil- 
dren. The  boy  was  telling  the  truth  and  being  censured  by 
his  class.  He  had  no  opportunity  for  self-expression  and 
no  chance  to  straighten  out  his  problem. 

At  another  time,  when  we  were  taking  visitors  to  the  Health 
schools,  the  teacher  was  in  a  great  flurry  and  asked  us  if 
we  would  wait  a  little  while.  We  later  discovered  that  the 
cause  of  the  delay  was  the  absence  of  the  Health  Club  cap- 
tain. They  sent  an  automobile  for  the  boy  and  would  not 
let  the  visitors  enter  until  the  captain  was  there.  That  club 
could  not  work  that  morning  without  the  captain.  Every- 
thing went  well  after  he  arrived ;  he  was  a  true  little  cap- 
tain and  put  the  children  through  their  paces  in  great  style. 
That  was  another  eye-opener  to  me.  I  knew  that  there  was 
something  wrong  somewhere  if  we  had  to  depend  on  one 
small  boy  to  make  the  club  a  success. 

Our  next  step  was  to  show  these  clubs  in  process  to  an 
administering  body  of  people  called  District  Principals.  It 
is  their  duty  to  look  at  new  material  for  Detroit  schools 
from  the  standpoint  of  its  administrative  possibilities.  They 
are  a  very  important  and  imposing  group  of  people  and  we 
took  all  fifteen  of  them  to  one  school.  They  were  not  nearly 
as  impressed  as  we  had  expected  and  immediately  found 


132 


The 

Present 
and  Most 
Successful 
Plan. 


all  sorts  of  difficulties  for  the  average  and  below  the  average 
school  to  contend  with: 

1.  The  assistant  supervisor  could  never  spend  all  that 
time  in  every  school. 

2.  These  teachers  were  above  average. 

3.  Too  much  temptation  to  prevaricate  for  the  sake 
of  public  approval. 

Many  more  minor  faults  were  found.  So  the  verdict  was 
thumbs  down  on  this  scheme  at  the  end  of  an  interesting 
and  illuminating  year. 

We  are  now  well  on  our  way  on  our  third  and  so  far,  at 
least,  our  most  successful  plan.  Mr.  N.  H.  Pearl  is  our 
Supervisor  of  Health  Instruction  and  he  put  in  at  the  be- 
ginning of  the  past  school  year,  six  months  of  constructive 
work  on  a  course  of  study  for  the  fourth,  fifth  and  sixth 
grades.  This  is  being  printed  by  the  Detroit  Board  of 
Education.  Mr.  Pearl  then  began  experimenting  in  four 
schools  of  different  types  of  children  and  teachers.  The 
outline  I  gave  you  at  the  beginning  of  this  talk  is  from  this 
course  and  he  worked  in  six  rooms  in  each  school  with  the 
six  major  problems.  Although  they  did  not  have  a  full 
term  the  results  were  very  satisfying  and  by  means  of  scrap 
books,  plays,  posters,  rhymes,  slogans,  songs,  health  clubs, 
student  committees,  campaigns,  competitions,  records,  out- 
side agencies,  national  and  local  organizations,  correlations, 
textbooks,  charts,  personal  experiences,  etc.,  it  was  sur- 
prising to  see  the  intelligence  of  these  children  upon  the 
subject  of  Health,  and  their  interest,  keenness  and  attention 
to  personal  habits.  This  time  we  divided  the  District  Prin- 
cipals among  the  four  schools,  and  a  far  wiser  move,  we 
choose  one  of  their  own  schools  to  experiment  in.  They 
were  all  satisfied  that  we  were  doing  worth  while  work,  and 
a  committee  from  among  their  number  is  helping  us  plan  an 
extensive  use  of  it  this  coming  year. 

Discussion 


Miss  Helen  Freeborn,  of  the  Washington  Junior  High 
School,  Rochester,  N.  Y.,  told  of  another  type  of  experience 
with  high  school  pupils.  She  said: 

"I  am  not  a  Director  of  Health  Education  and  I  am  not  associated 
in  any  way  with  the  Health  Education  Department  of  Rochester,  N.  Y. 
I  am  a  mere  member  of  the  faculty  of  the  Washington  Junior  High 
School.  In  addition  to  and  apart  from  its  Health  Education  teachers 


133 


and  their  work,  we  try  to  do  something  to  formulate  health  habits  in 
that  school.  As  in  Detroit,  our  Department  of  Physical  Education  is 
called  Health  Education.  You  probably  know  that  the  Modern  Health 
Crusade  was  founded  upon  the  Health  Club  idea  as  originated  in 
Rochester,  N.  Y.  The  Washington  Junior  High  School  has  nearly 
2000  pupils  and  100  teachers.  It  is  a  school  in  which  there  are  four 
distinct  methods  of  training — academic  work — commercial  work — 
vocational  work  for  boys  and  vocational  work  for  girls.  We  have  un- 
usual facilities  and  unusual  means  for  carrying  on  any  project  that 
we  start,  because  we  have  the  things  to  work  with.  One  morning  in 
the  spring  of  1920  a  boy  came  into  our  school.  He  had  moved  from 
Binghamton  to  Rochester  and  among  his  credentials  was  his  report 
card  and  at  the  top  of  that  was  printed  'Health  Education,  — its  object 
is  to  make  health  habits  through  education — to  add  years  to  the  lives 
of  the  coming  generation — and  to  increase  people  in  their  efficiency 
and  habits  by  the  training  they  receive  today/  Below  that  were 
spaces  for  marking  the  pupil  in  personal  appearance,  school  house- 
keeping, posture,  play  activities  and  classwork  in  hygiene. 

"The  same  morning  three  of  our  foreign  children  had  been 
sent  to  the  basement  to  be  cleaned  up,  because  they  were  so 
unusually  dirty.  That  same  morning  a  large  poster  had  been  put  in 
the  main  hall.  On  that  poster  were  7  Objectives  of  Secondary  Educa- 
tion with  Health  heading  the  list.  Perhaps  it  was  the  combination  of 
circumstances,  but  the  thought  came  to  us  why  cannot  we  organize 
some  plan  by  which  the  children  in  our  school  may  be  cleaned  up  and 
may  start  health  habits?  The  matter  was  talked  over  with  the  prin- 
cipal, and  a  committee  was  formed  to  investigate  what  was  being 
done  in  other  places  along  the  line  of  Health  Education  and  to  see 
what  might  be  done  in  perhaps  a  very  simple  way  at  first  to  start 
health  habits  in  our  school.  I  am  not  going  into  details  about  what 
we  did,  but  the  result  of  the  committee  was  that  we  have  organized 
an  annual  Health  Campaign  in  our  school,  which  takes  place  during 
the  last  ten  weeks  of  the  spring  term.  The  first  Health  Campaign 
was  called  Cleanliness  Crusade,  and  we  stressed  only  questions  which 
had  to  do  with  personal  cleanliness  and  the  cleanliness  of  clothing. 
We  put  in  the  regular  class  inspection,  which  has  stayed,  and  we  used 
the  slogan — 'Cleanliness  is  the  Citadel  of  Health  and  Happiness.'  In 
the  second  Health  Campaign  our  slogan  was  'Health  Through  Clean- 
liness Leads  to  Happiness.'  We  added  to  the  cleanliness  rules  of  the 
year  before  a  few  rules  about  health.  The  third  campaign  this  spring 
we  called  a  'Happiness  Drive'  and  we  used  as  our  slogan  'Hap- 
piness Through  Health  and  Cleanliness.' 

"The  justification  of  this  method  of  promoting  health  habits  can, 
of  course,  only  be  made  through  the  results  obtained,  and  we  feel 
that  we  have  obtained  results.  I  am  going  to  tell  you  a  few. 

"We  have  in  every  home  room  (there  are  59  in  our  school),  a  daily 
health  inspection,  particularly  for  cleanliness.  In  all  our  plans  we 
had  to  remember  that  the  work  was  being  done  by  teachers  who  were 
not  trained  in  Health  Education  and  that  the  time  was  limited.  We 
have  student  government  in  our  school,  and  practically  all  of  in- 
spection is  done  by  student  officers.  The  Health  Campaign  is  so  in- 


Health 
Education 
Permeating 
a  Junior 
High  School 
Curric- 
ulum. 


134 


The  Trans- 
formation 
of  Peter. 


The 

Modern 

Health 

Crusade  in 

a  School 

Health 

Program. 


tensive  during  the  ten  weeks  that  the  work  is  carried  over  into  the 
next  year.  Another  important  result  of  the  campaign  is  that  there 
is  not  a  coat  or  sweater  worn  by  any  boy  in  school  from  September 
until  June.  The  girls  have  also  adopted  middies  as  their  universal 
uniform. 

"We  have  on  each  report  card  a  space  for  marking  pupils  in  Health 
Education.  Before  I  close  I  should  like  to  tell  you  the  story  which 
illustrates  the  effect  upon  our  children  of  bringing  to  them  forcibly 
the  importance  of  health  habits  during  their  school  days. 

"We  had  in  school  an  Italian  boy — Peter  Gambetta — who  was  the 
most  uncouth  and  most  unpromising  and  roughest  and  dirtiest  pupil. 
In  about  a  year  he  elected  vocational  work  and  went  to  the  machine 
shop.  He  had  no  self-control,  no  sense  of  the  rights  of  others,  and 
finally  he  was  suspended  from  school  because  of  his  conduct.  His 
father  came  down  to  plead  for  him  and  he  was  readmitted  to  the 
school.  About  this  time  our  First  Health  Campaign  started.  Peter 
was  simply  transformed.  He  was  one  of  the  boys  who  took  up  the 
Health  Campaign  with  the  greatest  seriousness  and  changed  into  a 
clean,  happy,  wholesome  boy.  He  graduated  from  the  9th  grade.  He 
wanted  to  go  on  further,  but  his  father  would  not  allow  this.  He 
wanted  Peter  at  home  to  work.  Peter  sent  for  the  teacher  to  talk  to 
his  father  and  we  sent  one  of  our  Vocational  Guidance  teachers.  His 
father  would  not  consent  to  his  going  to  school  any  longer.  While 
waiting  for  his  father  to  come,  Peter  showed  the  teacher  how  he  had 
worked  at  home.  He  had  taught  his  mother  how  to  wash  dishes 
properly.  He  had  painted  the  walls  and  woodwork  of  his  house  and 
had  made  an  attempt  to  paper  one  room ;  he  had  scrubbed  and  cleaned 
the  floors  and  had  even  attempted  and  succeeded  in  making  a  dress 
for  his  little  sister  so  that  she  might  go  to  school  looking  like  the 
other  children.  He  had  10  brothers  and  sisters.  One  of  his  brothers 
came  to  me  one  day  and  brought  with  him  two  other  boys.  He  said 
to  me:  'These  two  boys  look  the  way  I  used  to  look — will  you  see  if 
you  can  do  something  for  them?' 

"Since  I  have  come  to  this  Conference  I  feel  there  are  a  great 
many  weaknesses  in  our  plan." 

Recurring  to  the  references  frequently  made  to  the 
Modern  Health  Crusade,  Professor  Turner  asked  Miss  Vir- 
ginia Lewis,  Director  of  the  Modern  Health  Crusade  of 
Ohio,  if  from  her  experience  of  the  Modern  Health  Crusade 
it  could  be  put  on  as  a  school  health  program,  or  whether  it 
has  a  different  type  of  place  as  an  initial  step  in  developing 
a  school  program. 

Miss  Lewis  replied : 

"None  of  us  feel  that  it  is  a  school  health  program.  It  is  a  method 
that  can  be  used,  but  I  think  it  is  a  method  only." 

Professor  Turner: 

"How  long  do  you  think  it  can  be  used  in  the  rural  school?  Is  the 
program  one  which  can  be  used  year  after  year?" 


135 


Miss  Lewis: 


"This  question  can  be  answered  by  the  practice  of  a  certain  south- 
ern county  superintendent  of  schools,  who  has  used  it  every  year, 
putting  it  on  as  two  programs — one  in  the  spring  and  one  in  the  fall." 

The  chairman  then  announced  the  next  paper  in  the 
series  of  Successes  and  Failures.  He  presented  Mrs. 
Isabelle  Baker,  Director  Instruction  in  Home  Hygiene  and 
Care  of  the  Sick,  National  Headquarters,  American  Red 
Cross,  Washington,  D.  C. 

Home  Hygiene  and  Care  of  the  Sick 

MAY  I  assume  that  everyone  here  believes  that  the  most 
important  thing  in  Health  Education  is  to  teach  the 
principles  of  health  and  right  living  in  addition  to  auto- 
matic health  habits? 

Children  should  be  taught  the  reasons  why  the  organs  of 
the  body  should  function  properly ;  why  personal  cleanliness 
is  necessary ;  why  harmful  results  follow  when  regularity  of 
life  and  simplicity  of  diet  are  not  cultivated. 

The  aim  of  the  Red  Cross  course  of  instruction  in  Home 
Hygiene  and  Care  of  the  Sick  is  to  give  such  practical  illus- 
trations of  the  subject  of  health  preservation  and  disease 
prevention  as  may  be  applied  at  once  to  self,  school,  family 
and  community.  The  objective  of  the  course  is  to  give  ele- 
mentary knowledge  of  personal  hygiene  and  household  and 
community  sanitation;  to  provide  authentic  instruction  for 
women  and  young  girls  in  simple  nursing  procedures  in 
order  that  they  may  care  for  members  of  their  own  families 
during  minor  ailments  and  that  they  may  also  be  prepared 
to  carry  out  intelligently  in  the  absence  of  a  graduate  nurse 
the  orders  of  the  physician,  and  learn  how  to  care  properly 
for  small  children  and  babies,  according  to  the  most  modern 
scientific  theories,  thereby  checking  infant  mortality.  The 
"ounce  of  prevention"  principle  is  an  integral  part  of  the 
course  in  Home  Hygiene  and  Care  of  the  Sick.  Safeguard- 
ing the  home  and  school  by  prompt  attention  to  early  symp- 
toms, application  of  the  principles  of  health  rules,  and  the 
control  of  communicable  diseases,  together  with  a  knowl- 
edge of  how  to  take  proper  care  of  babies,  children  and 
mild  illnesses  is  surely  the  A  B  C  of  common  sense  as  well 
as  of  a  national  Health  Education  program. 


136 

Moreover  has  not  the  schoolgirl  of  today  the  right  to 
expect  some  direction  toward  her  future  duties?  Upon 
her  will  eventually  rest  the  responsibilities  of  making  a 
home,  keeping  her  family  well  and  happy.  We  must  visual- 
ize her  future  as  wife,  mother,  club  member,  as  a  person 
sharing  with  the  sterner  sex  civic  responsibilities  and  per- 
haps political  ambitions,  as  well  as  a  potential  business  or 
professional  woman.  New  vocations  continually  evolve 
for  the  twentieth  century  graduate.  She  may  be  the  sani- 
tary engineer  of  the  community  and  State  in  the  years  to 
f *foWf  come-  Should  we  not  keep  pace  with  the  march  of  events 
Girls  for  by  giving  her  such  health  education  as  will  enable  her  to 
Modern  accept  intelligently  and  efficiently  such  a  destiny?  To  a 
great  extent  the  health  of  the  nation  must  always  depend 
upon  its  womanhood.  Can  we  afford  to  ignore  the  oppor- 
tunity to  ground  our  girlhood  so  securely  upon  health  prin- 
ciples while  youth  and  enthusiasm  make  the  task  most 
simple,  that  maturity  will  find  them  ardent  disciples  of  the 
goddess  Hygiea? 

Perhaps  no  subject  in  the  school  curriculum  may  be  so 
practically  linked  up  with  allied  sciences  and  branches  of 
study  as  Home  Hygiene  and  Care  of  the  Sick.  Even  the 
High  School  boy  may  be  induced  to  take  an  interest  in  the 
subject,  through  the  Manual  Training  Department,  for  one 
of  the  most  important  phases  of  the  course  is  the  teaching 
how  to  improvise  sick  room  appliances  and  substitutes  for 
costly  hospital  apparatus  and  bedside  comforts  out  of  sim- 
ple materials  at  hand,  at  almost  no  expense  and  trifling 
labor. 

Similarly  the  sequence  from  biology  to  physiology  sug- 
gests itself,  in  the  presentation  of  the  lessons  in  Home  Hy- 
giene and  Care  of  the  Sick.  The  cooperation  of  the  sewing 
teacher  is  readily  enlisted  when  child  care  brings  up  the 
subject  of  layettes:  of  the  instructor  in  home  economics 
when  the  invalid's  tray  is  prepared  and  sick  diets  pre- 
scribed. 

It  should  be  borne  in  mind  that  primarily  Home  Hygiene 
and  Care  of  the  Sick  is  not  a  course  in  Health  Education 
and  was  never  intended  as  such,  but  it  is  a  phase  of  it  and  in 
the  schools  may  be  regarded  as  an  elective  or  required  sub- 
ject for  a  selected  group  whose  study  has  consistently  led  up 
to  this  supplementary  instruction.  Such  a  group  of  High 
School  girls,  for  example,  is  the  ideal  material  with  which 


137 

to  work.  Its  study,  however,  is  not  limited  to  any  particular 
grade  or  group.  The  subject  matter  is  capable  of  extensive 
modification  and  adaptation. 

Whenever  home  hygiene  instruction  is  made  a  part  of 
the  High  School  curriculum  the  subject  matter  of  the  text- 
book must  be  divided  and  presented  in  a  simpler  and  more 
concrete  way  than  is  necessary  when  instructing  classes  for 
adults,  for  whom  the  textbook  was  primarily  written.  It 
is  scarcely  necessary  for  me  to  say  to  this  audience  that  the 
pupils  in  the  High  Schools  (Graded,  Parochial  or  Private) 
are  not  only  immature  but  are  inexperienced  in  life  as  well. 

Moreover  the  customary  periods  of  each  lesson  in  the 
adult  course,  consisting  of  from  one  and  one-half  to  two 
hours,  are  entirely  too  long  for  the  school  girl.  Further- 
more the  average  period  in  High  Schools  is  forty  minutes,  a  High 
fact  which  has  necessitated  an  additional  adaptation  of  the  conditions. 
text  in  the  presentation  of  the  subjects.  During  the  past 
three  years  we  have  been  endeavoring  to  have  a  double 
period  once  a  week  set  aside  in  High  Schools  for  this  in- 
struction, but  we  have  taken  the  time  allotted  and  adapted 
the  course,  accordingly.  Our  experience  has  shown  also 
that  it  is  quite  often  impossible  in  the  case  of  school  pupils 
to  meet  the  requirement  of  the  American  Red  Cross  to  keep 
the  classes  small — preferably  14  to  16 — because  a  class 
must  be  taken  in  its  entirety,  regardless  of  its  membership. 
The  class  may  number  20  or  30,  who  must  take  the  instruc- 
tion in  a  given  period  of  only  forty  minutes'  duration. 

A  solution  of  the  school  period  problem  consists  in  ac- 
cepting the  group  as  a  whole  for  instruction  in  principles 
and  for  demonstration  work;  afterward  breaking  up  the 
group  into  smaller  units — four,  six  or  eight — for  their 
laboratory  or  technical  class  work.  Such  methods  fre- 
quently obtain  in  colleges  and  universities  in  the  case  of 
subjects  where  practical  demonstrations  or  personal  re- 
search work  is  required  and  has  worked  out  very  effectively 
in  the  case  of  Home  Hygiene  and  Care  of  the  Sick,  especially 
in  rural  districts. 

The  best  results  are  obtained  when  a  room  is  set  aside 
for  this  particular  instruction  fitted  up  to  resemble  as 
nearly  as  possible  an  ordinary  bedroom  in  an  average  home. 
I  cannot  too  strongly  emphasize  the  fact  that  the  simpler 
the  equipment  the  more  valuable  the  lesson.  If  a  girl  is 
taught  a  simple  nursing  procedure  for  the  home,  with 


138 


Value  of 
Working 
with 
Home- 
made Ap- 
pliances. 


hospital  equipment,  she  is  not  going  to  remember  in  the 
stress  of  emergency,  or  under  the  strain  of  anxiety  when 
a  member  of  her  family  becomes  ill,  something  that  was 
perhaps  casually  mentioned  in  the  class  as  a  "practicable 
substitute."  Whereas,  if  she  has  worked  from  the  begin- 
ning with  home-made  appliances,  substitutes  and  simple 
home  apparatus  she  will  not  lose  her  head  but  will  be  able 
to  proceed  with  confidence  and  efficiency. 

My  criticism  of  many  of  the  classrooms  equipped  in  the 
schools  for  this  course  is  that  they  lack  the  home  atmos- 
phere and  have  too  much  of  the  appearance  of  a  hospital 
ward. 

Regarding  the  question  of  credits,  our  experience  has 
shown  us  that  Home  Hygiene  and  Care  of  the  Sick  is  just 
as  often  allowed  credit  as  a  separate  subject  as  when  cor- 
related with  another  subject.  In  one  school  the  course  is 
correlated  with  English,  receiving  one  Regent's  count.  In 
a  number  of  schools  it  receives  one  point  toward  their 
credits  for  hygiene,  which  is  a  required  subject.  In  others 
the  same  is  true  with  reference  to  gymnasium,  biology, 
home-making,  etc.  All  of  which  points  to  the  practicability 
of  including  it  in  the  curriculum. 

In  passing  I  must  not  fail  to  call  attention  to  the  far- 
reaching  possibilities  of  building  through  this  course  of  in- 
struction closer  relations  between  the  school  and  the  home, 
and  in  fact,  the  entire  community.  Whenever  exhibits  are 
held,  featuring  the  school  work,  the  interest  of  the  parents 
is  centered  in  a  two-fold  way  upon  Home  Hygiene  and  Care 
of  the  Sick.  First,  through  the  demonstrations  given  by 
the  girls  of  such  simple  nursing  procedures  as  are  capable 
of  public  exhibition ;  second,  through  the  home-made  appli- 
ances made  by  the  boys  in  the  manual  training  department. 
The  family  and  the  neighbors  and  friends  are  awakened 
to  the  value  and  far-reaching  benefits  of  Home  Hygiene  and 
Care  of  the  Sick  by  just  such  means,  and  every  interested 
observer  becomes  a  potential  advertisement  for  the  exten- 
sion not  only  of  the  course  itself,  but  of  attention  to  health 
and  hygiene  in  the  community  at  large. 

The  place  this  course  has  won  for  itself  in  the  estima- 
tion of  school  boards  is  shown  by  the  action  taken  in  the 
State  of  Arkansas,  where  one  of  the  best  known  school 
systems  has  already  taken  the  further  step — following  the 
State  adoption  of  the  course  toward  which  the  State  author- 


139 

ities  are  working  —  of  making  Home  Hygiene  and  Care  of 
the  Sick  a  required  course  in  the  Home  Economics  De- 
partment. 

The  instruction  has  been  given  in  many  schools  as  part 
of  the  curriculum  in  different  localities  all  over  the  country, 
including  the  Philippines.  In  many  instances  the  local  Red 
Cross  Chapter  provides  the  nurse  instructor,  the  equip- 
ment and  even  the  textbooks,  as  a  demonstration  of  its 
value  to  the  school  girl  and  the  community.  But  in  many 
more  instances  it  has  been  the  principal  of  the  High  School 
who  requested  the  Red  Cross  to  furnish  an  instructor  for 
the  course  which  was  to  be  added  as  a  regular  part  of  the 
curriculum. 

Home  Hygiene  and  Care  of  the  Sick  is  a  subject  that 
every  girl,  no  matter  what  her  individual  bent,  finds  inter- 
esting. There  is  such  variety  in  the  scope  of  the  instruction 
that  whether  hers  is  the  scientific,  the  practical,  the  im- 
aginative or  the  creative  type  of  mind,  before  she  has 
progressed  very  far  in  its  study  she  finds  some  phase  of  it 
peculiarly  fitted  to  her  own  individuality  and  inclinations. 

As  an  Americanization  agent,  and  as  a  solid  foundation 
upon  which  to  build  an  enduring  structure  of  social  stand-  as  an 


ards  and  civic  fitness,  especially  in  the  cases  of  that  class 
of  young  women  who  do  not  complete  their  education,  but  Agent. 
who  must  become  wage-earners  at  an  early  age,  or  who 
marry  young,  the  value  of  Home  Hygiene  and  Care  of  the 
Sick  is  incalculable.  In  a  certain  locality  on  the  Pacific 
Coast,  for  example,  most  of  the  pupils  are  of  Mexican  blood. 
This  type  of  girl  marries  very  young  and  probably  has  had 
little  in  the  school  curriculum,  which  is  calculated  to  fit  her 
for  her  domestic  duties.  It  is  scarcely  possible  to  over- 
estimate the  immense  practical  value  of  this  course  in  en- 
abling her  to  live  her  own  life  successfully  and  to  rear  chil- 
dren that  will  not  be  a  drain  upon  the  State  because  of 
improper  care. 

In  its  immediate  benefits  to  the  individual,  the  family 
and  the  community,  this  course  is  of  fundamental  and  far- 
reaching  value.  Every  girl,  whether  she  continues  her 
career  as  a  wage-earner  and  professional  woman,  or  enters 
politics  and  public  service,  is  fitted  to  be  a  more  healthy 
and  useful  member  of  society  herself,  and  a  more  successful 
and  happy  wife  and  mother  because  of  the  knowledge 


140 


gained  through  this  instruction  in  Home  Hygiene  and  Care 
of  the  Sick. 

In  short,  the  successes  and  failures  of  Health  Education 
depend — I  think — upon  how  well  the  scientific  facts  have 
been  applied  by  the  pupil  to  herself  in  her  everyday  life. 


Junior 

High 

School 

Successes 

in  "Home 

Hygiene.' 


Discussion 

Miss  Rood  then  led  the  discussion  of  the  above  paper, 
as  follows: 

There  are  certain  points  in  Mrs.  Baker's  paper  which 
I  should  like  to  emphasize  in  a  concrete  way — using  as  a 
basis  a  very  successful  piece  of  work  which  is  now  in 
progress  in  the  two  High  Schools  of  Tacoma,  Washington. 

The  first  class  in  Home  Hygiene  consisting  of  twelve 
students  was  organized  three  years  ago,  as  a  unit  of  the 
Home  Economics  department — under  the  immediate  di- 
rection of  the  public  health  nurse  for  the  High  Schools. 
The  class  has  grown  to  4  classes  with  a  total  enrollment  of 
108  students,  open  only  to  Junior  A's,  Seniors  and  Post- 
Graduates.  The  classes  meet  forty-five  minutes  daily  for 
one  semester,  %  point  credit  being  given  as  well  as  the 
Red  Cross  certificate.  Beginning  next  September,  Cooking 
I.  will  be  required  of  all  students  taking  the  Nursing 
Course.  This  announcement,  which  was  made  only  re- 
cently, resulted  immediately  in  the  enrollment  of  three  large 
cooking  classes  in  each  High  School.  Previously  there  had 
been  one  cooking  class. 

Scope  of  the  Course 

The  Red  Cross  course  is  covered — with  such  adaptations  as  are 
necessary  to  fit  the  particular  needs  of  the  students.  In  outlining 
the  course,  the  aim  has  been  to  relate  it  closely  with  other  subjects  in 
the  curriculum  which  have  a  bearing  on  health,  and  to  bring  about  a 
discussion  of  practical  problems.  In  arranging  this,  Mrs.  Smith,  the 
nurse,  seems  to  be  peculiarly  prepared  to  infuse  into  this  course  the 
elements  which  are  vital  if  the  knowledge  is  to  function  in  the  lives 
of  the  students.  In  the  first  place  she  knows  the  health  condition  of 
the  students;  she  knows  intimately  the  social  problems  arising  in  the 
school,  and  their  relationship  to  these  health  problems.  She  knows 
the  living  conditions  in  many  of  the  homes,  and  in  special  cases  she 
perhaps  has  more  intimate  data  than  anyone  else.  She  has  a  knowl- 
edge of  health  conditions  as  found  in  the  community  at  large,  and 
because  her  work  brings  her  into  close  contact  with  other  health  and 
social  agencies  she  is  able  to  give  these  young  students  a  clear  idea  of 


141 

their  place  in  the  municipal  health  program  and  to  rouse  a  sense  of 
responsibility  for  health  conditions  in  the  school. 

In  going  over  the  plans  for  the  work  we  find  incorporated  into  the 
entire  program  specific  study  of  three  aspects  of  health  teaching. 
First — Promotion  of  personal  health.  Second — Protection  of  health, 
which  topic  includes  methods  of  early  recognition  and  prevention  of 
infections,  first  aid  in  emergencies,  and  the  simple  nursing  care  of  the 
person  in  the  home  who  has  deviated  from  the  health  path.  Third — 
Promotion  of  community  health  and  the  opportunity  and  responsi- 
bility which  the  student  has  now  in  working  out  health  problems. 

Method  of  Presentation 

The  course  is  made  alive  by  class  discussion,  demonstra- 
tions, simple  talks,  and  personal  reports  of  student  inves- 
tigation and  reading,  visits  to  institutions  which  exemplify 
the  effort  of  the  community  to  meet  health  situations,  and 
most  important  of  all  by  the  participation  of  all  students  in 
the  health  activities  of  the  school. 

I  shall  select  at  random  from  the  outline  certain  points 
which  will  show  the  way  in  which  these  activities  appear 
in  the  program. 

1.  A   demonstration   of   examination   of  eyes,   nose,  throat,  Outstand- 
teeth;   also  weighing  and  measuring.  Jfc£  " 

2.  Equipment  of  a  cabinet  for  use  in  the  emergency  room  of 
the  school. 

3.  A  tour  of  inspection  with  the  engineer  of  the  school. 

4.  Talks   by   nutrition    specialist.     Planning  a   day's  menu 
showing  an  adequate  diet. 

5.  A  visit  to  the  local  dairies. 

6.  A  talk  by  the  Superintendent  of  Mountain  View  Sanitar- 
ium for  Tuberculosis,  and  a  visit  to  the  institution. 

How  is  this  made  to  function  in  the  lives  of  the 
students  ? 

1.  Every  student  in  the  course  assists  at  some  time  in  the  health 
examination  room  when  three  hundred  to  three  hundred  and  fifty  How  It 
freshmen  are  admitted  in  the  fall.     By  the  time  these  examinations   Works  in 
are  over,  the  students  are  able  to  recognize  the  ordinary  defects  found   ™e  school. 
in  children.     One  girl  said  to  Mrs.  Smith  not  long  ago,  "I  see  more 
children  now  with  adenoidal  faces  and  malnourished  children,  when 

I  never  noticed  any  before." 

2.  Every  student  serves  in  the  Red  Cross  emergency  room  for  a 
certain  period  of  time.    All  are  anxious  to  do  their  share,  and  gladly 
donate  their  study  period  for  this  work.     A  great  deal  of  practical 
work  is  obtained  in  this  way.     A  daily  record  sheet  is  kept,  giving 
date,  pupil's  name,  roll  room,  for  what  purpose  he  came  in,  and  the 
name  of  the  girl  in  charge,  as  well  as  a  record  of  what  was  done.   No 
one  is  allowed  to  come  in  except  in  emergency,  without  a  slip  from 
the  teacher.     The  room  service  is  open,  however,  to  boys  and  girls, 


142 

if  there  is  need  of  care  and  advice.  That  they  feel  free  to  come  in 
is  shown  by  the  fact  that  they  frequently  come  to  have  a  sore  leg  or 
arm  "well  bandaged"  before  going  to  a  wrestling  match  or  into  the 
football  game.  Follow-up  work  is  done  on  any  case  needing  further 
attention. 

3.  Every  student  assists  in  weighing  and  measuring  the  students, 
helps  select  underweights  who  are  to  receive  special  attention.   These 
students  also  assist  in  the  regular  weekly  weighing  of  the  nutrition 
class.     Working  in  close  cooperation  with  the  Home  Economics  de- 
partment, nourishments  are  furnished  these  students  at  10:30  each 
day.     The  cooking  class  makes  the  nourishments,  the  Home  Hygiene 
girls  serve  them,  wash  and  boil  the  glasses  and  return  them  to  the 
cooking  room. 

4.  The  students  in  the  course  are  constantly  on  the  watch  for  sus- 
picious symptoms  in  the  student  body.  One  of  the  students  recently  on 
duty  in  the  Red  Cross  room  came  to  the  nurse  and  said,  "Mrs.  Smith, 
I  just  saw  a  boy  in  the  hall,  with  something  on  his  face  that  looked 
like  impetigo.    I  don't  know  his  name  but  I  know  what  room  he  went 
to.    May  I  go  and  get  him?"    She  did  get  him  by  asking  the  teacher  to 
send  the  boy  with  the  breaking  out  on  his  face  to  the  Red  Cross  room. 
The  eruption  proved  to  be  a  bad  case  of  impetigo. 

The  students  often  bring  or  send  in  cases  of  scabies.  If  they  see 
anyone  with  a  suspicious  eruption  they  step  up  to  them  and  cour- 
teously advise  them  to  go  to  the  Red  Cross  room. 

Works* in  ^^e  Practical  knowledge  gained  in  the  course  is  used  in 

the  Homes,  many  ways  in  the  homes.  Advice  is  frequently  requested 
regarding  special  home  conditions  which  involve  beside 
care,  first  aid  treatment,  child  care  and  feeding.  Occa- 
sionally a  girl  comes  to  ask  just  how  to  do  certain  things 
for  a  mother  who  is  in  bed.  Advice  is  asked  about  dressings 
for  the  injured  father  or  brother  at  home. 

Many  mothers  come  to  tell  how  much  their  girls  have 
enjoyed  the  course  and  how  valuable  it  has  been.  Several 
are  sending  their  daughters  to  take  hospital  training  after 
first  consulting  with  the  nurse  regarding  the  choice  of  a 
training  school. 

The  knowledge  gained  by  Mrs.  Smith  from  private  con- 
ferences with  the  school  principal  regarding  social  offenses, 
talks  with  the  school  physician,  home  visits,  contacts  with 
student  organizations,  with  the  Woman's  Protective  Divi- 
sion, with  the  tuberculosis  nurses,  visiting  nurses,  has  a 
definite,  though  sometimes  inconspicuous  place  in  this  plan 
for  health  promotion. 

One  occasion  which  seems  to  give  the  greatest  oppor- 
tunity for  connecting  closely  and  in  a  dramatic  way  the 
work  in  this  department  and  the  Physical  Education  de- 


143 

partment  with  the  general  community  activity,  conies  every 
year  in  the  celebration  of  the  Annual  Stadium  Day, — an 
affair  in  which  every  school  in  the  city  takes  part  before 
an  audience  of  approximately  50,000  people. 

A  tent  is  furnished  as  a  first  aid  station,  the  Home  Hygiene  girls 
planning  the  entire  equipment,  including  also  a  cot,  stretcher,  and  a 
car,  which  is  usually  donated  by  some  student  who  also  gives  volun- 
teer service  in  case  it  is  necessary  to  send  some  one  home. 

This  year  four  Home  Hygiene  girls  were  assigned  to  each  of  the 
26  sections  of  the  Stadium,  reserving  four  for  the  tent.  The  boys'  gym- 
nasium teacher  provided  two  boys  to  be  on  call  as  stretcher  bearers. 
All  were  supplied  with  arm  bands  to  designate  to  the  public  that  they 
were  there  for  service. 

As  it  happened  the  two  boys  provided  were  two  of  the  most  mis-  Enlisting 
chievous  boys  in  school,  members  of  a  group  calling  themselves  the  the  Boys' 
"Dirty  Dozen."    One  was  the  son  of  a  prominent  doctor  and  one  the  C°°Pera~ 
son  of  a  prominent  undertaker.     One  of  the  boys  remarked  that  he 
wished  they  would  remember  their  respective  professions  if  they  were 
needed. 

This  year  Stadium  day  was  unusually  warm  and  as  the  children 
had  to  stand  in  line  for  some  time  preparing  for  a  mass  formation,  it 
was  necessary  to  carry  several  to  the  tent.  The  boys  soon  found  that 
they  needed  more  help,  so  brought  six  more  members  of  the  "Dirty 
Dozen,"  who  said  if  they  could  have  an  arm  band  they  would  be  glad 
to  work.  Of  course  they  could  not  possibly  have  worked  without  the 
arm  band.  When  the  service  sheet  was  totaled  for  the  day  it  was 
found  that  the  eight  boys  had  carried  91  children  and  six  adults  to  the 
tent.  Not  one  of  the  boys  and  girls  stationed  at  the  tent  saw  any  of 
the  exercises,  with  the  exception  of  one  boy  who  said,  "I  saw  the  field 
once  when  you  sent  me  over  the  top  for  another  mattress." 

A  waiting  list  of  boys  who  have  volunteered  for  next  year's 
Stadium  day  is  already  on  file.  One  member  of  the  faculty  re- 
marked :  "I  think  it  was  a  stroke  of  genius  to  interest  those  particular 
boys  in  this  work  and  to  keep  them  busy — for  you  may  be  sure  they 
would  have  been  doing  something.  They  were  certainly  a  credit  to 
the  school." 

You  can  appreciate  the  spirit  which  must  permeate  a 
group  of  young  people  who  gladly  deny  themselves  the 
pleasure  of  witnessing  a  program  of  sports  and  dramatics 
for  participation  in  organized  group  service. 

If  every  course  in  Home  Hygiene  could  be  made  as  alive 
and  dynamic  as  this  one  there  would  be  no  question  of  its 
place  in  the  High  School  program. 

The  success  of  the  work,  I  believe,  is  due  first  to  the 
personality,  enthusiasm  and  personal  example  of  the  in- 
structor, who  is  a  firm  believer  in  the  value  of  health,  and 
its  direct  relationship  to  efficient  living;  second,  to  the  cor- 


144 

dial,  whole-hearted  way  in  which  the  entire  school  staff  has 
supported  the  program  for  health. 

The  thing  which  I  believe  has  been  awakened  and  which 
is  of  much  more  importance  than  the  actual  skill  in  the  care 
of  the  sick  is  the  consciousness  that  health  is  an  absolutely 
live,  vital  thing  which  is  simply  invaluable  to  every  boy  and 
girl. 

Dr.  Brydon,  Director  of  Child  Welfare,  Virginia  State 
Board  of  Health,  in  indorsing  these  views,  stated : 

"We  have  Home  Nursing  classes  in  Virginia.  Two  hours  a  week 
for  the  whole  year  is  given  to  cooking  and  two  hours  to  sewing — one 
hour  for  one  semester  to  Household  Management,  and  in  last  semester 
one  hour  a  week  is  given  to  Home  Nursing.  The  State  Board  of 
Health  worked  up  the  course,  and  we  are  giving  credit  in  those 
schools.  I  believe  there  are  38  of  them." 

The  chairman  at  this  point  asked  for  further  accounts 
of  experiences,  successful  or  otherwise. 

Miss  Estella  Bogardus,  Executive  Secretary,  Yonkers 
Tuberculosis  Association,  in  speaking  of  the  work  of  her 
Association,  said  that  at  the  present  time : 

"The  greatest  stress  is  being  laid  upon  the  care  and  work  that 
can  be  done  with  children,  because  infection  takes  place  most  often  in 
childhood. 

"When  I  came  down  here  from  Yonkers,  I  thought  our  work  in  the 
schools  of  Yonkers  had  been  pretty  well  completed  and  that  we  could 
take  up  another  branch  of  the  work.  But  since  I  have  been  listening 
here  I  have  made  up  my  mind  very  definitely  that  what  we  want  is 
an  appeal  to  provide  funds  for  an  instructor  in  Health  Education  to 
put  on  a  demonstration.  After  we  make  the  demonstration  for  one 
or  two  years,  then  it  will  be  possible  for  us  to  get  the  Department  of 
Education  to  incorporate  it  in  the  school  program.  This  is  the  way 
most  of  the  health  work  has  been  put  on  in  Yonkers." 

Miss  Jean  added  to  Miss  Bogardus's  remarks  that  the 
reason  that  the  work  had  been  so  successful  was  that  the 
Association  had  been  willing  to  stand  back  and  have  the 
schools  and  the  Health  Department  credited  with  the  work. 

Miss  Perrin,  referring  to  the  great  helpfulness  of  many 
extra-school  organizations  in  a  health  program,  said: 

"We  use  the  Scouts  a  great  deal  in  Detroit — both  the  Camp  Fire 
girls  and  the  Girl  Scouts  are  helping  very  largely  in  emergency  work. 
They  are  a  very  vital  influence,  and  should  be  in  all  public  school 
work." 


145 

Miss  Anna  Ruth  Medcalf,  R.  N.,  Line  Fork  Settlement, 
Kentucky   (Pine  Mountain  Settlement  School),  said: 

"I  have  not  any  plans  or  programs  to  bring  to  you,  but  I  would 
like  to  tell  you  some  of  the  difficulties,  not  failures,  peculiar  to  our 
region.  Our  valley  is  very  remote.  A  Ford  automobile  cannot  come 
within  15  miles  of  us.  We  have  two  teachers  and  a  public  health 
nurse.  We  have  great  distances  and  difficult  trails  to  make.  I  deal  „  . , 
with  one  person,  where  many  of  you  deal  with  hundreds.  The  trails  Education 
are  long  and  rough  and  narrow,  and  it  is  very  silent  and  lonely — all  under  Dif- 
that  one  hears  is  the  creak  of  the  saddle  and  the  wood  creatures.  The  ficulties. 
geographical  difficulties  are  great.  Our  people  have  been  isolated 
for  so  long  that  they  are  not  anxious  to  take  our  advice  immediately. 
One  of  them  told  me  this  story:  'I  dreamed  I  went  up  on  the  ridge 
back  of  our  school  house,  and  I  saw  a  big  Mother  Bear,  and  along 
with  her  came  three  Baby  Bears,  and  she  said  to  them,  "Step  just 
where  I  step."  Our  folks  down  there  are  still  stepping  in  the  steps 
of  their  fathers  and  mothers.  I  try  to  put  on  a  little  school  program. 
I  go  to  the  school  house  and  talk  to  the  children  and  take  them  pictures 
— they  have  no  supplementary  readers.  Health  talks  and  posters 
thrill  them.  One  mother  said  'It  is  a  sight  to  see  how  those  youngsters 
like  the  pictures.'  I  talk  to  them,  play  with  them  and  tell  them  fairy 
stories.  They  have  a  keen  imaginative  sense.  But  though  I  often  get 
discouraged,  we  know  we  are  sowing  seeds  in  their  minds  which  will 
grow  and  perhaps  one  of  these  days  they  will  carry  out  in  their  own 
homes  the  things  I  am  trying  to  get  across.  One  school  house  is  a 
little  log  cabin.  There  are  windows  in  it,  of  course.  There  are  no 
blackboards.  We  write  on  the  walls.  The  seats  are  not  attached  to 
the  floor,  and  it  is  a  good  thing  they  are  not.  The  chinking  between 
the  logs  has  fallen  out,  and  the  children  stick  mosses  in.  We  have  to 
move  the  seats  around  to  keep  out  of  the  leaks.  The  stovepipe  does 
not  reach  up  to  the  roof,  and  if  there  is  a  fire  in  the  stove,  and  it 
gets  too  hot,  the  roof  catches  fire,  so  we  spend  most  of  the  time  putting 
the  fire  out. 

"I  am  trying  to  spread  the  Gospel  of  Health  anywhere  and  every- 
where I  can.  You  all  do  not  realize  the  problem,  when  perhaps  100 
per  cent,  of  the  children  have  hookworm,  and  the  teachers,  too.  And 
trachoma  is  frequent  also.  In  nutrition  they  are  100  years  behind 
the  times.  We  have  to  overcome  these  conditions  before  we  can  do 
anything.  It  is  no  good  talking  to  them  about  drinking  milk,  for  if 
they  have  a  cow,  it  is  not  well  fed  and  does  not  give  enough  milk. 
They  do  not  know  how  to  feed  the  cows  or  till  the  farms. 

"But  I  think  we  have  some  material  to  work  on.  We  must  have 
education  of  all  sorts.  The  teachers  have  a  third  or  fourth  grade 
education.  The  County  Superintendent  is  not  very  well  educated,  nor 
are  the  doctors,  preachers — anybody.  We  work  single-handed,  and  we 
have  to  be  content  with  little  victories. 

"One  day  I  went  to  see  a  schoolchild's  little  brother,  who  was 
sick.  I  brought  the  older  boy  back  with  me  to  my  cabin  and  gave  him 
a  dose  of  castor  oil  to  take  back  to  the  baby.  I  asked  the  child  if  he 
had  his  supper,  and  he  said:  'Yes,  mum,  I  have,  but  I  hain't  washed 


146 


Methods 
and  De- 
vices Con- 
tributory to 
Success. 


my  teeth  yet.'  We  have  toothbrush  drills.  In  one  community  I  have 
been  trying  to  impress  them  with  the  necessity  of  brushing  their 
teeth.  They  have  no  toothbrushes,  so  we  use  dogwood  sticks  and  go 
through  the  motions  and  they  get  the  idea.  They  promised  to  use  the 
sticks  twice  a  day,  and  they  are  trying.  Two  rural  schools  have  taken 
to  using  handkerchiefs.  It  is  a  habit  absolutely  unknown  to  their 
parents. 

"I  could  go  on  indefinitely.  Water  in  the  schools  is  usually  brought 
from  springs — sometimes  they  have  a  bucket  and  sometimes  not,  and 
if  not,  they  fall  down  flat  on  the  ground  and  drink. 

"You  can  see  how  successes  in  our  remote  country  are  hard  to 
wrest  from  so  unprepared  a  people,  and  so  unopened  a  country.  You 
can  realize  that  we  can  have  few  successes  without — oh — so  many 
more  workers  than  are  now  prepared." 

Dr.  Wilkes,  by  request  of  a  member  of  the  Conference, 
gave  the  following  list  of  factors  that  had  contributed  to 
success  in  Trenton.  He  said: 

"In  Trenton  we  have  found  that  the  interest  of  the 
teachers,  children  and  nurses  is  stimulated  by: 

1.  Graphs  showing  improvement  of  children  within  a  school 
— plotted  by  teachers.     (Exhibit.) 

2.  Same,  plotted  by  schools  for  the  city.     (Exhibit.) 

3.  Intensive  study  and  demonstration  of  individual  case  of  a 
child,  with  explanations  for  various  deviations  in  rate  of  gain 
shown.      (Exhibit.) 

4.  Height     and    weight    charts    with    classification     stars. 
(Exhibit.) 

5.  Circulating    libraries,    i.    e.,    sets    of    health    books    and 
pamphlets  on  various  health  subjects  to  be  loaned  to  teachers 
for  definite  length  of  time. 

6.  Photographs  of  interesting  cases  of  physical  improvement. 

7.  Special  lectures. 

8.  Playlets — preferably  original  and  worked  out  in  correla- 
tion with  regular  grade  work. 

9.  Health  Booklets — prepared  by  the  children — Rules  of  the 
Game  and  daily  scores;  menus  for  breakfast,  dinner  and  supper 
(and  recipes  for  proper  preparation  of  them)  illustrated  by  cut- 
out pictures  from  magazines,  original  drawings  in  colors  (crayons 
or  water-colors)   or  in  black  and  white  effects. 

10.  Exchange  letters — both   within  and  without  the  system, 
from  children,  teachers,  organizations,  clubs,  showing  apprecia- 
tion or  offering  new  suggestions. 

11.  Slides  and  films.     These  are  often  available  from  many 
free  sources,  viz.: 

a.  Ford  Motor  Co.  Educational  health  films  through  local 

dealer. 

b.  National    Dairy    Council — through   local    dairy   com- 

panies. 

c.  State  Museum  or  Library  often  have  health  subjects. 


147 

d.  Many  local  and  State  departments  of  health  have  loan 

films  and  slides. 

e.  Many  organizations  (especially  dental  or  medical  so- 

cieties) can  be  induced  to  finance  the  purchase  or 
even  the  preparation  of  an  original  film  or  set  of 
slides. 

f.  National    nursing    and    public    health    organizations 

have  films  at  nominal  rental  cost  for  loan. 

12.  Costumes  and  "props"  for  playlets. 

13.  Jingles,  compositions,  etc.,  in  competition. 

14.  Health  Clubs  and  morning  inspection. 

15.  Periodical   exhibitions   of  projects   or   improved   children 
to  the  class. 

16.  Malnutrition — A  determination  of  what  could  be  accom- 
plished by  purely  educational  methods  conducted  by  the  teachers 
who  were  kept  informed  of  the  condition  of  each  child  was  at- 
tempted this  year.     The  work  was  entirely  self-supporting,  ex- 
cept for  the  salary  of  Miss  Sparks,  who  aided  in  the  supervision 
of  teachers'  work  in  the  schools  and  collected  the  best  methods 
devised  by  the  teachers.     Nutritional  information,  especially,  for 
the  training  of  teachers  in  food  classification  and  value  was  our 
most  prominent  effort  this  year,  but  only  very  elementary  facts 
were  deemed  to  be  of  practical  value  to  the  teacher  and  child. 
Food  games,  posters,  menu  books  and  other  projects,  height  and 
weight  records  with  classification  "stars"  were  used  successfully. 
Milk  periods  were  established  in  most  schools  and  4000  children 
took  milk  in  school.     Many  others  drank  milk  at  home.    Every 
child  knew  his  height  and  weight  and  his  gain  or  loss  at  each 
weighing,  and  comparison  with  the  "average"  for  his  age  and 
height  gave  material  for  the   arithmetic  lesson.     Graphs  were 
kept  before  teachers  and  pupils  to  stimulate  interest. 

17.  Teeth — A  dental  survey  of  the  pupils  by  our  dentist   (a 
Forsyth  Dental  Infirmary  man)   has  impressed  us  that  a  clean 
tooth  is  not  always  a  healthy  tooth  and  vice  versa.    The  correla- 
tion between  decayed  teeth  and  nutrition  in  our  studies  is  not 
strictly  accurate  because  in  the  better  grade   (socially)   districts 
more  dental  repair  work  obtains,  and  these  schools  will  not  show 
the  true  correlation  of  tooth  decay  with  the  nutritional  studies. 

18.  Re-examination  of  pupils — Many  defects  were  improved 
and  previous  recommendations  were  withdrawn.    We  grow  more 
conservative  with  experience  in  diagnosis  of  certain  defects. 

With  the  presentation  of  these  "helps"  the  session  on 
Successes  and  Failures  came  to  a  close. 


Section  V 

THE  PREPARATION  OF  TEACHERSUN 
HEALTH  EDUCATION 

THE  stock-taking  step  in  the  Conference  had  now  been 
reached.  A  great  mass  of  material  on  the  "What,"  and 
the  "When,"  and  the  "How,"  of  Health  Education  had 
been  presented — some  of  it  essential,  some  of  it  desir- 
able— some  of  it  in  the  province  of  the  classroom  teacher, 
and  some  of  it  in  that  of  the  specialist.  The  outstanding 
and  self-evident  fact,  however,  was  that  teachers,  to  put 
across  these  plans,  first  needed  training,  and  then  later, 
needed  the  assistance  and  guidance  of  competent  super- 
visors. How  then,  to  plan  the  equipment  of  teachers  for 
this  work,  was  the  topic  of  the  last  session  of  the  Con- 
ference. 

As  the  person  who  has,  perhaps,  had  the  largest  group 
of  contacts  with  teachers,  Dr.  Williard  S.  Small,  of  the  U. 
S.  Bureau  of  Education,  was  asked  to  make  the  first  ad- 
dress on  this  subject. 

The  Preparation  of  Teachers-in-T raining 

Dr.  Small: 

I  FEEL  as  though  I  were  bringing  to  you  tonight,  if  not 
exactly  the  "funeral  baked  meats,"  at  least  some  cold 
dishes  of  thought.  It  happens  that  the  Round  Table  group 
which  is  considering  the  problem  of  teacher  preparation 
held  a  meeting  last  night,  and  in  the  course  of  the  discus- 
sion I  expressed  pretty  fully  my  views  upon  that  subject. 
I  come  before  the  full  Conference  this  evening  and  am  ob- 
liged to  try  to  warm  over  and  make  palatable  what  I  said 
last  night.  I  hope  it  will  not  be  less  nutritious  for  being 
warmed  over. 

The  matter  of  teacher  preparation  in  its  relation  to 
Health  Education  is  not  single  and  simple.  In  the  first 
place  we  must  remember  there  are  many  teachers  already 
on  the  job  who  need  some  re-education,  some  further  devel- 
opment. On  the  other  hand,  there  are  the  teachers  in 
process  of  making,  in  the  schools  and  colleges  for  the  prep- 


149 

aration  of  teachers.    A  fairly  definite  line  of  demarcation 
lies  between  these  two  classes.     Second,  there  is  the  dis- 
tinction between  those  who  are  to  be  the  leaders  in  this 
special  field  and  those  who  are  to  be  just  teachers — the  Different 
every-day  leaders  of  children.    Here  is  another  fairly  dis-  Type 
tinct  line  of  demarcation.     Again,  there  is  a  marked  dif-  I™Ztt/^ 
ference  between  the  preparation  of  High  School  teachers  ferentType 
and  Elementary  School  teachers — the  difference  between  Workers- 
preparing  for  departmental  teaching  in  one  case  and  for 
"general  teaching"  in  the  other  case.  Further,  in  the  country 
and  city,  conditions  differ,  and  certain  things  that  are  rea- 
sonable and  feasible  in  city  conditions  are  not  reasonable 
and  feasible  in  country  conditions.     Finally,  there  is  the 
problem  of  the  individual  who  is  being  educated.     This 
problem  is  first  of  the  individual  as  an  individual ;  and  sec- 
ond, of  the  individual  as  a  teacher. 

In  order  to  keep  myself  within  reasonable  bounds,  I 
shall  confine  myself  tonight  to  a  discussion  of  the  prepara- 
tion of  the  teachers-in-training  in  Normal  Schools  and  col- 
leges who  are  preparing  for  the  vocation  of  teaching — those 
who  are  to  be  the  every-day  leaders  of  children  in  the 
school.  I  am  assuming  this  limitation  because  I  know  that 
Professor  Turner  will  want  to  talk  about  the  training  of 
those  who  are  to  be  the  specialists  and  supervisors  in  this 
field.  Furthermore,  the  things  that  are  essential  in  the 
preparation  of  regular  teachers  are  fundamentally  essential 
for  those  who  are  to  lead  and  supervise  teachers. 

The  first  thing  I  want  to  say  in  regard  to  this  matter  is 
that  after  all,  in  spite  of  apparent  popular  belief  to  the 
contrary,  the  teacher  is  a  human  being;  the  teacher  loves 
and  hates,  and  eats  and  sleeps  and  lives  in  a  general  way 
like  other  people.  The  teacher  has  a  personal,  individual 
life.  Sometimes,  in  looking  over  the  programs  for  teacher 
training  I  am  almost  persuaded  that  teachers  are  thought 
of  not  as  human  beings  at  all  but  merely  as  relaying  mech- 
anisms through  which  schedules,  forms  and  cultures  are 
automatically  transmitted  to  children.  I  want  to  make  a 
plea  tonight  for  the  teacher  as  a  human  being;  and  for  the 
education  of  the  teacher  as  a  rational  and  whole  human 
being.  In  so  doing,  I  am  not  at  all  unaware  of  the  im- 
portance of  what  we  are  pleased  to  call  the  professional 
training  of  teachers;  but  I  want  at  this  time  to  emphasize 
especially  the  importance  of  the  education  of  the  individual 


150 

as  the  matrix  of  professional  training.  I  am  quite  aware 
that  there  are  many  persons  —  perhaps  there  are  some  right 
here  —  who  think  that  the  supply  of  human  talent  in  this 
world  is  so  small  that  we  cannot  expect  very  many  talented 

—  even  reasonably  talented  —  individuals  among  teachers; 
and  that  therefore  it  is  not  worth  while  to  try  to  develop 
the  personality  of  teachers  but  is  worth  while  only  to  train 
them  to  execute  programs.     That  the  supply  of  talent  or 
superior  intelligence  is  fairly  meager,  is  not  a  new  dis- 
covery.   It  is  an  old  fact.    It  does  not,  however,  justify 
shifting  the  emphasis  in  the  preparation  of  teachers  from 
personal  development  to  program  execution,  in  preparing 
teachers  for  the  instruction  and  leadership  of  children. 
And  especially  in  preparing  them  to  instruct  and  lead  chil- 
dren with  respect  to  wholesome  living,  they  must  be  guar- 
anteed experience  out  of  which  may  come  understanding 
and  appreciation  of  wholesome  living. 

From  this  point  of  view  there  are  three  or  four  things 
that  are  essential  in  the  organization  of  the  institutional  life 
where  the  young  woman  of  18,  19,  or  20  years  of  age  (the 
day  of  the  man  in  the  Elementary  Schools  is  largely  passed) 
is  to  spend  two  or  three  years  preparing  to  teach.  I  am  not 
attempting  to  give  what  follows  in  the  order  of  importance. 
Perhaps  all  of  the  factors  mentioned  are  equally  important 

—  with  the  exception  of  the  first. 

portance  of        First  of  all  I  would  emphasize  the  educational  signifi- 
tke  Con-       cance  of  the  individual  health  examination  and  the  service 


°^  conference>  consultation  and  advice  that  inevitably  grow 
Examina-  out  of  a  good  health  examination.  If  the  educational  pos- 
sibilities of  this  form  of  service  are  to  be  realized  —  and 
they  can  be  realized  —  we  must  get  our  thinking  straight 
in  regard  to  three  or  four  matters. 

First,  the  health  examination  is  not  merely  an  isolated 
event  at  the  time  the  student  enters  the  school.  It  is  rather 
the  essential  first  step  in  establishing  a  right  relation  be- 
tween the  examiner  and  the  individual  student  whereby 
the  student  may  be  continuously  influenced  as  needed 
throughout  her  stay  in  the  institution.  It  means  subsequent 
re-examination,  consultation,  conference  and  advice  in  ac- 
cordance with  individual  needs.  Second,  the  health  exami- 
nation must  not  be  thought  of  as  solely  or  primarily  a  matter 
of  discovering  diseases  and  defects.  Of  course,  it  must  do 
that  and  it  must  point  the  way  for  correction  and  remedy 


151 

in  cases  where  specific  disabilities  are  found.  But  the  edu- 
cational purpose  and  opportunity  are  realized  only  when 
the  pathological  atmosphere  is  avoided.  The  doctor-patient 
complex  must  be  dissolved.  Students  must  come  to  feel 
that  the  examination-conference-advice  procedure  is  en- 
tirely normal.  This  will  come  about  if  the  examination  and 
the  information  resulting  from  the  examination  are  used 
for  individual  instruction  and  guidance. 

And  this  takes  us  quite  naturally  to  the  third  matter  The 
of  importance.    We  have  been  told  over  and  over  again  in 
this  Conference  that  health  is  a  good  deal  more  than  physi-  Takes  Cog- 
cal  condition — that  mental  hygiene  bulks  large  in  the  mat-  #^f^ 
ter  of  individual  and  social  health.  The  health  examination,  Attitudes. 
therefore,  is  quite  as  much  concerned  with  finding  out  the 
habits  and  attitudes  of  the  student  as  in  finding  out  ana- 
tomical and  physiological  conditions. 

May  I  be  forgiven  for  turning  aside  for  a  moment  into 
an  alluring  bypath?  Health,  both  in  concept  and  reality, 
is  a  fairly  complex  thing  in  spite  of  the  enthusiasms  of  the 
monists  in  the  realm  of  hygiene.  So  persuasive  are  the 
monists,  however,  that  at  different  times  we  are  almost 
persuaded  that  health  is  merely  a  matter  of  freedom  from 
infection,  or  of  properly  tending  and  feeding  the  alimentary 
canal,  or  of  dissolving  unrecognized  complexes,  or  of  assur- 
ing hormonic  saturation  of  the  organism  or  of  something 
else.  My  only  excuse  for  this  digression  is  to  emphasize 
the  fact  that  the  health  examination  must  be  broad  in  con- 
ception and  wise  in  execution.  And  that  means,  to  quote 
Dr.  Croasdale,  that  it  must  be  "leisurely";  and  that  there 
must  be  provision  of  time  for  following  up  the  "leads"  for 
individual  instruction  and  guidance. 

The  examination-advisory  service  thus  conceived  becomes 
the  instrument  for  effecting  the  most  vital  kind  of  individ- 
ual education.  It  hits  the  students  where  they  live ;  and  the 
things  that  are  merely  academic  when  presented  academi- 
cally become  personal  when  treated  in  this  individual  way 
Sometimes  the  method  is  drastic.  I  recall  an  incident  told 
to  me  recently  by  the  Dean  of  Women  of  a  State  Teachers 
College.  A  girl  came  to  the  physician  in  a  hysterical  con- 
dition. She  recited  her  tale  of  woe  for  about  15  minutes, 
winding  up  with  the  ejaculation,  "What  shall  I  do?  Oh! 
What  shall  I  do?"  The  doctor  didn't  tell  her  what  to  do, 
but  said  quietly,  "Do  you  want  to  know  exactly  what  is  the 


152 


"Thou 

Who  are  to 
Teach 
Must 
Know." 


matter  with  you?"  "Yes!"  "Well,  the  matter  is  that  you 
are  so  monumentally  selfish  that  you  cannot  be  anything 
but  a  nuisance  if  you  do  not  get  over  it."  Nothing  about 
complexes!  Perhaps  the  method  was  not  psychoanalyti- 
cally  correct,  but  the  girl  straightened  up,  left  in  anger  and 
had  not  had  a  similar  attack  for  months  when  the  story 
was  told  to  me.  Incidentally,  the  doctor  was  a  woman. 

I  am  not  going  to  discuss  details  or  difficulties  at  this 
time.  My  sole  aim  at  this  time  is  to  present  to  you  the  idea 
of  the  health  examination  as  an  educational  procedure. 
That  this  conception  of  the  health  examination  is  logical 
needs  little  argument;  that  it  is  practicable  I  can  assure 
you  out  of  personal  observation  and  experience  with  a  num- 
ber of  institutions  where  the  idea  is  successfully  operated. 

The  second  important  element  in  a  program  for  the 
preparation  of  teachers  to  do  good  health  work  in  the 
schools  will  be  inevitably  a  knowledge  of  hygiene.  Those 
who  are  to  teach  must  know.  They  must  have  a  substantial 
body  of  knowledge.  I  will  not  attempt  to  discuss  the  details 
of  what  that  body  of  knowledge  should  include — we  have 
a  committee  wrestling  with  that  problem — but  I  want  to 
express  my  agreement  with  Dr.  Winslow  and  others  that 
teachers  or  other  individuals  must  have  a  substantial  body 
of  sound  scientific  knowledge  if  they  are  to  function  suc- 
cessfully. Please  keep  in  mind  that  I  am  emphasizing  all 
the  time  the  education  of  the  individual  as  an  individual. 
Such  knowledge  is  essential  as  a  matter  of  constructive 
personal  welfare,  but  it  is  quite  as  important  as  a  defensive 
measure.  It  has  been  pointed  out  by  other  speakers  in  this 
Conference  that  knowledge,  in  a  measure  at  least,  is  pro- 
phylactic against  quackery  and  charlatanism.  Not  long 
ago  I  visited  a  college  class  in  hygiene  in  which  the  topic 
under  discussion  was  a  phase  of  heredity.  The  instruction 
was  good,  entirely  sound  and  scientific,  and  yet  so  handled 
as  to  be  intelligible  to  the  student.  The  constantly  recur- 
ring question  was  that  of  pre-natal  influences.  Every  stu- 
dent seemingly  knew  of  some  case  of  marvellous  pre-natal 
influence.  Each  case,  so  far  as  time  permitted,  was  ana- 
lyzed and  the  validity  or  invalidity  of  the  case  was  shown. 
I  am  not  sure  that  these  students  were  all  convinced,  but  I 
am  sure  that  they  received  clear  and  accurate  information 
in  harmony  with  present  scientific  knowledge  of  pre-natal 
influences.  I  am  sure  that  some  of  these  students  were 


153 

convinced.  Whether  the  conviction  will  be  good  for  a  life- 
time is  another  matter.  The  same  doubt  might  arise  in 
connection  with  any  knowledge  or  conviction. 

The  third  thing  that  seems  very  important  to  me  is  Living 
that  the  conditions  of  living  in  the  institution  shall  be 
wholesome.  I  have  not  time  to  elaborate  this  point,  but  WMesome. 
by  wholesome  conditions  of  living  I  mean  something  more 
than  sanitary  physical  environment.  The  water  supply, 
the  sewerage,  the  ventilation,  and  other  sanitary  conditions 
may  be  right,  and  yet  the  conditions  of  living  may  be  un- 
wholesome. By  way  of  illustration,  one  institution  with 
which  I  am  very  well  acquainted  for  years  had  a  daily  sched- 
ule such  that  no  student  could  possibly  get  enough  sleep. 
As  the  result  of  a  survey  made  last  year  by  the  Director 
of  Hygiene,  the  schedule  was  so  changed  that  an  hour  was 
added  to  the  sleeping  time  of  the  students.  It  is  quite  as 
important  that  the  regimen  of  the  institution  shall  be  whole- 
some as  that  the  physical  environment  shall  be  sanitary. 
Furthermore,  it  concerns  the  programs  and  modes  of  living 
of  the  individual  students  as  well  as  the  regimen  of  the  in- 
stitution as  a  whole. 

Fourth  and  final,  it  is  essential  that  provision  be  made  "Joy-Pro- 
for  abundant  invigorating,  joy-producing,  physical  activity  physical 
— physical  education  in  its  true  sense,  as  applied  to  students  Activity." 
of  this  age.     This  is  a  matter  that  will  not  take  care  of 
itself,  as  is  abundantly  shown  by  the  fact  that  the  situation 
in  most  Normal  Schools  with  respect  to  material  facilities, 
time-allotment  and  competent  leadership  is  far  from  satis- 
factory.    There  cannot  be  outdoor  sports  and  games  with- 
out space  for  the  same  and  without  time  and  without  com- 
petent leadership.    The  students  need  such  physical  activi- 
ties, not  only  for  "keeping  fit  purposes,"  but  also  as  experi- 
ence upon  which  may  be  based  the  special  training  for 
leadership  in  physical  activities  of  children. 

To  recapitulate:  We  are  dealing  with  individuals,  and 
if  we  are  going  to  prepare  young  men  and  young  women 
to  be  good  teachers  of  health  we  must  do  all  that  can  be 
done  to  make  them  acquainted  with  health  in  themselves. 
To  this  end,  four  things  are  surely  essential:  First,  the 
health  examination,  educational  in  purpose  and  method; 
second,  sound  instruction  in  hygiene;  third,  wholesome  liv- 
ing conditions  where  the  students  are  undergoing  prepara- 


154 


The 

New^  York 

Training 

School 

Health 

Education 

Course. 


tion;  and  fourth,   provision   for   wholesome   recreational 
physical  activities. 

Discussion 

The  Chairman  then  explained  that  Dr.  Howe,  State 
Medical  Inspector  of  Schools,  State  Department  of  Educa- 
tion, Albany,  N.  Y.,  had  been  prevented,  through  illness, 
from  coming  to  the  Conference,  and  that  he  had  asked  Dr. 
Franklin  Barrows  to  take  his  place.  Dr.  Barrows  spoke 
as  follows: 

"Dr.  Small  has  spoken  of  the  health  examination  as  the  first  essen- 
tial. I  might  say  that  it  is  one  of  the  greatest  essentials  in  the  prepara- 
tion of  the  teacher.  I  contend  that  a  teacher  who  has  been  subjected 
to — better  still,  who  has  sought — an  annual  examination,  though  it 
may  be  only  for  the  two  or  three  years  that  she  is  in  training;  who  has 
understood  this  examination  because  it  has  been  well  explained  to 
her;  who  has  tried  honestly  to  profit  by  it  in  order  that  she  may 
increase  the  positive  side  of  her  health  account  will  be  so  impressed 
with  its  value  that  she  will  want  all  those  she  teaches  to  follow 
in  her  way. 

"We  cannot  make  a  human  machine  efficient  if  we  do  not  devote 
to  it  the  attention,  or  the  small  amount  of  time,  that  we  devote  to 
the  ordinary  machinery  of  the  farm  and  kitchen.  When  you  sug- 
gest a  yearly  examination  of  the  Normal  School  student,  there  are 
always  educators  who  want  to  know  what  that  has  to  do  with  teach- 
ing. I  would  also  add  to  the  annual  examination  a  demonstration  of 
the  annual  examination  and  the  follow-up  work  as  applied  to  the 
pupil  and  practiced  upon  the  children  of  the  Observation  School,  and 
I  think  perhaps  Dr.  Small  intended  to  include  this  in  what  he  said. 

"I  agree  with  Dr.  Small  that  a  thorough  scientific  knowledge  of 
hygiene  is  essential.  For  this  reason — and  others — there  should  be 
careful  censorship  and  careful  examination  of  the  qualifications  of 
those  who  come  into  the  Normal  Schools  to  teach." 

Miss  C.  M.  Scovel,  of  the  New  York  Training  School 
for  Teachers,  here  described  the  present  course  in  that  in- 
stitution thus: 

"Our  two-year  course  for  students  is  in  the  experimental  stage, 
and  I  will  give  you  briefly  details  of  the  course  we  have  given  this 
past  year.  We  found  it  was  very  necessary  to  have  personal  hygiene. 
The  examination  of  the  Juniors  when  they  came  to  our  school  was 
given  to  me.  The  nutrition  work  was  also  with  Juniors,  with  whom 
we  have  had,  in  addition,  a  Method  Course  which  has  been  my  special 
work.  With  that  course  we  have  taken  up  the  study  of  our  city 
syllabus  quite  thoroughly,  and  in  connection  with  that  we  have  gone 
into  the  Model  School  for  students  to  see  the  observation  work,  which 
has  been  very  helpful  and  interesting.  We  talked  to  the  teacher  and 
found  out  what  lesson  was  to  be  given;  we  talked  it  over  with  the 


155 

students  and  we  saw  the  lesson.  Following  the  lesson,  the  teacher 
came  to  my  room  and  we  discussed  it.  The  students  were  then  asked 
to  write  a  paper  on  their  observations,  which  involved  quite  a  little 
correlation  with  other  subjects. 

"I  also  bring  to  the  students  material  from  outside,  and  we  make 
a  little  Hygiene  Catalog,  listing  reference  books  and  telling  where 
and  how  to  obtain  different  materials.  In  making  catalogs  the  stu- 
dents correlate  with  the  Art  Department  in  the  decoration  and  with 
the  Librarian  in  the  arrangement.  In  method  work  we  also  have 
borders  and  charts  passed  upon  by  the  Art  Department. 

"These  two  courses,  Personal  Hygiene  and  Methods,  not  only  deal 
with  teaching  hygiene  in  the  grades,  but  certain  other  procedures 
and  questions  come  up — for  example,  skin  diseases.  The  method  of 
inspection  is  taken  up  and  opportunity  for  practice  is  given.  The 
students  go  down  with  me  to  see  the  nurse  or  teacher  give  the 
inspection,  and  we  have  it  once  a  month  in  our  own  room. 

"In  our  syllabus  there  come  up  such  subjects  as  industrial  hy- 
giene, which  we  think  very  important  because  so  many  of  our  chil- 
dren go  out  from  the  sixth  grade  into  factories  and  work. 

"In  the  Senior  work  the  students  have  had  a  course  in  physi- 
ology, but  that  will  not  be  the  final  arrangement,  because  we  think 
that  physiology  and  personal  hygiene  should  come  at  the  beginning. 
The  question  came  up  in  one  of  my  examinations  as  to  where  the 
tonsils  were  located,  and  the  answer  was,  'The  tonsils  are  located 
at  the  end  of  the  palate — hanging  down.'  The  need  of  physiology  is 
very  great." 

Dr.  Alvin  Powell,  Director  of  Health  Development,  Oak- 
land Health  Center,  Oakland,  California,  said  that  he  would 
like  to  see  added,  in  the  case  of  the  girl  who  is  being  taught 
in  the  Normal  School,  not  only  a  physical  examination  but 
a  requirement  that  before  she  graduates,  she  make  such 
corrections  as  have  been  found  necessary,  and  that  it  also 
be  made  a  requirement  of  the  graduation  that  she  have  a 
dental  prophylaxis  once  a  year. 

Dr.  Wilkes,  referring  to  the  training  of  teachers  in  Nor- 
mal Schools,  had  the  following  to  offer: 

"Since  there  are  always  available  so  many  teachers  and 
since  the  child's  health  can  be  markedly  influenced  by  the 
teacher,  she  should  be  trained  for  health  teaching — in  Nor- 
mal School  preferably.  If  not,  then  in  the  school  system. 
What  shall  the  various  specialists  contribute  to  the  Health 
Education  of  the  embryo  teacher? 

"First — I  should  place  full  realization  and  appreciation  of  her 
obligation  for  the  child's  physical  as  well  as  mental  improvement.  In 
the  business  vernacular  of  the  day,  she  must  be  "sold"  the  idea  of 
health  as  definitely  as  she  has  been  the  idea  of  mental  development 
in  education. 


156 


Health 
Specialists 
not  Always 
Health 
Teachers. 


"Second — I  should  impress  upon  her  that  example  is  more  than 
precept.  She  cannot  successfully  talk  health  and  happiness  and  still 
exemplify  'death  and  destruction.'  Improved  physical  condition  of 
children  and  herself  and  not  knowledge  is  the  gauge  of  her  ability  in 
Health  Education. 

"Third — She  should  learn  of  the  child's  present  habits  as  to  use  or 
abuse  of  'The  Rules  of  the  Game'  and  impress  upon  him  the  value 
and  necessity  of  the  constant  regular  and  effective  application  of 
these  rules  until  they  become  automatic,  i.  e.,  HABITS. 

"Fourth — In  her  Normal  School  training  the  teacher  should,  be 
given  a  background  of  such  parts  of  anatomy  and  physiology  as  will 
enable  her  to  answer  intelligently  and  reason  convincingly  as  to  the 
value  and  efficiency  of  any  health  habit  advocated,  or  answer  any 
ordinary  pertinent  question  that  a  pupil  may  ask  about  health 
preservation. 

"N.  B.    She  is  not  expected  to  discuss  disease  with  children. 

"Every  teacher  should  be  equipped  before  graduation  from  the 
Normal  School  to  aid  in  the  promotion  of  health.  Every  teacher  can 
do  this.  Some,  perhaps,  better  than  others,  as  in  every  calling,  but  all 
must  be  trained  and  aid  in  the  work.  Teaching  is  an  art  which  has 
its  own  technique — especially  in  the  elementary  grades,  where  Health 
Education  is  most  urgently  needed.  Unfortunately,  this  fact  is  not 
sufficiently  appreciated  by  most  health  specialists,  and  often  those 
who  possess  the  'content'  or  material  feel  themselves,  thereby,  most 
able  to  teach  it  to  children.  This,  I  believe,  is  a  great  factor  in  re- 
tarding Health  Education  in  the  Public  Schools.  Unfortunately, 
also,  the  teacher  has  been  supplied  with  very  limited  material  or  left 
to  her  inherited  notions  on  health  matters,  by  the  public  health 
workers  who  are  best  fitted  to  supply  this  material  through  such  Con- 
ferences as  this.  Textbooks  we  find  are  hard  to  use  below  fifth 
grade.  The  Health  Educator  can  bridge  this  gap  and  bring  about 
real  cooperation  between  the  two  agencies." 

Miss  Lewis,  having  in  mind  the  statements  made  re- 
garding the  importance  of  health  and  happiness  to  the 
teacher  herself,  raised  the  following  important  point: 

"Is  there  anything  that  can  be  done  to  better  the  living  conditions 
of  the  teacher  in  the  rural  communities?  Because  the  people  who  have 
had  rather  superior  training,  the  people  who  would  be  willing  and 
able  to  get  over  a  health  program,  are  not  the  type  of  teachers  who 
are  going  into  the  rural  schools,  since  the  living  conditions  are  so 
bad  that  they  cannot  stand  it  for  very  long.  There  may  be  some 
solution;  I  do  not  attempt  to  offer  any,  but  I  want  you  to  think  of  it, 
because  all  the  rural  communities  need  it." 

Dr.  Wood  then  presented  the  next  speaker  on  the  pro- 
gram, Professor  C.  E.  Turner,  Assistant  Professor,  Depart- 
ment of  Biology  and  Public  Health,  Massachusetts  Institute 
of  Technology,  Cambridge,  Mass. 


157 

The  Training  of  Specialists  in  Health  Education 

Professor  Turner: 

THERE  is  a  story  of  a  countryman  who  bought  an  old 
and  rather  decrepit  horse,  and  started  to  haul  some 
wood  through  a  college  town.  As  he  proceeded,  one  stick 
after  another  was  jolted  from  the  load  without  his  noticing 
it  and  most  of  the  wood  which  could  not  of  its  own  accord 
climb  down  from  the  cart,  was  assisted  by  some  of  the  col- 
lege students  as  the  old  man  drove  past  the  campus.  Di- 
rectly after  passing  the  college  he  was  obliged  to  drive  over 
a  piece  of  muddy  road.  In  the  midst  of  one  of  these  mud- 
puddles  the  old  horse  stopped.  The  man  looked  around,  be- 
held the  empty  cart,  and  said  in  the  greatest  dismay,  "Stuck, 
by  gosh,  and  nothing  to  unload." 

I  find  myself,  indeed,  in  a  very  similar  position  when  I 
rise  to  discuss  the  Preparation  of  Teachers  in  Health  Edu- 
cation before  a  Conference  of  experts  which  has  for  three 
days  held  round  table  discussions  upon  teacher  training. 
At  a  Conference  of  this  sort  one  sometimes  feels  that  he 
should  precede  any  formal  statement  with  a  "confession  of 
faith"  and  a  recitation  of  the  health  creed  to  which  his  par- 
ticular denomination  subscribes,  in  order  that  his  point  of 
view  may  not  be  confused  with  the  different  beliefs  of  other 
people.  We  recognize,  of  course,  the  many  different  views 
which  prevail  in  different  sections  of  the  country  regarding 
what  should  constitute  a  proper  health  instruction  program, 
but  it  seems  to  me  that  the  general  agreement  of  viewpoint 
in  this  Conference  has  been  remarkably  unified.  We  are 
interested  as  a  group  in  teaching  health  to  all  children  and 
we  appear  to  realize  in  a  very  sane  and  generous  manner 
the  contribution  which  the  various  people  who  take  part  in 
a  school  health  program  have  to  make.  From  the  teacher, 
nurse,  physician,  dentist,  and  the  specialist  in  physical  ac- 
tivities, we  have  definite  contributions.  We  are  here  inter- 
ested in  rounding  out  a  program  particularly  of  health 
instruction,  without  forgetting  all  the  other  phases  of  school 
health  work. 

The  discussions  of  this  Conference  have  demonstrated 
that  hygiene  is  not  merely  a  theoretical  subject  but  a  prac- 
tical science  upon  which  is  based  in  part  the  fine  art  of 
living.  I  am  not  worried  regarding  the  outcome  of  what 


158 


Results. 


some  have  felt  to  be  an  apparent  contradiction  between 
science  on  the  one  hand,  and,  on  the  other  hand,  the  inter- 
pretation of  science,  which  sometimes  becomes  so  free  as 
to  merit  the  ill-sounding  name  of  "propaganda."  The  De- 
partment of  Biology  and  Public  Health  at  the  Massachusetts 
Institute  of  Technology,  under  the  leadership  of  the  late 
William  T.  Sedgwick,  has  been  specially  training  people  for 
public  health  work  during  the  last  thirty  years.  We  have 
always  been  concerned  to  give  our  students  exact  informa- 
.  tion  and  to  see  that  no  student  secured  credit  who  did  not 

thusiasmto  have  both  a  basic  and  detailed  scientific  knowledge  of  the 
subject.  But  we  were  rather  pleased  when  the  Child  Health 
Organization  came  along  and  said  that  these  dry  bones  — 
hygiene  and  physiology  —  shall  live  again,  because  we  be- 
lieve that  with  the  scientist  insisting  that  the  information 
shall  be  correct,  and  with  the  interpreter  or  teacher  using 
every  available  means  to  make  these  facts  real  in  the  lives 
of  children,  we  shall  secure  a  practical  and  effective  Health 
Education  program  which  will  prolong  thousands  of  lives. 
I  am  not  sure  that  one  should  even  rebel  at  being  called  an 
enthusiast,  because  it  is  possible  to  be  enthusiastic  and  at 
the  same  time  scientific. 

We  are  further  recognizing  at  this  Conference  that  the 
grade  teacher  is  the  foundation  stone  upon  which  our  health 
instruction,  particularly  in  the  lower  grades,  must  be  built. 
The  previous  speaker  has  dealt  with  the  training  which 
should  be  provided  in  our  Normal  Schools  and  Teacher- 
Training  Institutions  for  those  people  who  are  to  become 
the  Elementary  School  teachers  of  the  future.  Another 
problem  which  has  not  received  treatment  at  so  great  a 
length  is  the  training  of  special  teachers  who  will  organize 
and  direct  the  Health  Education  program,  for  we  would 
agree,  I  suppose,  that  a  school  health  system  must  have 
some  efficient  supervision  if  the  instruction  is  to  be  unified 
and  if  the  interest  is  to  be  sustained.  There  may  be  or- 
ganized at  various  places  in  this  country  special  courses  of 
training  for  this  kind  of  specialist. 

I  shall  at  first  deal  with  neither  of  the  two  above  men- 
tioned problems,  but  with  the  somewhat  more  immediate 
problem  of  supplemental  training  for  the  teachers  who  are 
already  in  the  field.  May  I  take  the  liberty  of  telling  you 
the  opportunities  for  training  which  we  are  providing  in 
Boston,  first,  for  the  general  or  grade  teacher,  and  second, 


159 

for  the  specialist?  It  is  not  vanity  which  prompts  me  to  do 
this,  because  we  are  not  confident  that  we  have  ideal 
methods.  It  would,  indeed,  be  much  easier  to  escape  criti- 
cism by  outlining  what  one  thinks  would  be  ideal  than  by 
stating  definitely  what  is  actually  being  done.  But  this  is  a 
place  where  we  profit  from  each  other's  experience  and  I 
am  asking  permission  to  discuss  our  own  work,  first  be- 
cause it  is  typical  of  the  sort  of  thing  which  can  be  done 
in  any  educational  center,  and  secondly  because  it  is  defi- 
nite and  specific  and  therefore  more  readily  provocative  of 
criticism  and  discussion. 

For  teachers  and  school  nurses  we  provide  special  sum-  Summer 
mer  courses  such  as  might  be  made  available  at  any  uni-  J^fS^r 
versity  where  there  is  a  department  of  public  health.  One  in  Health 
course  is  offered  in  Methods  of  Teaching  Hygiene  and  Education' 
Public  Health  in  the  Public  Schools.  This  subject,  how- 
ever, has  a  somewhat  broader  interpretation  for  the  word 
"methods"  than  that  given  to  it  in  a  Conference  of  special- 
ists such  as  this.  In  this  course  we  outline  the  nature  of  a 
sound  and  complete  school  health  program,  indicating  the 
part  taken  by  the  various  professional  workers  and  the 
possibility  of  liaison  between  the  various  groups.  Following 
this  we  discuss  grade  by  grade  the  instruction  program  for 
the  Elementary  Schools,  indicating  a  variety  of  methods 
which  may  be  adopted,  providing  for  the  student  in  so  far 
as  possible  a  complete  list  of  teaching  aids  and  sources  of 
both  information  and  inspiration.  There  is  an  exchange  of 
experiences  in  the  class  and  there  are  visitations  to  places 
where  various  kinds  of  child  health  work  are  being  carried 
on  in  the  vicinity  of  Boston.  Such  a  course,  we  believe, 
gives  the  teacher  a  broader  perspective  and  a  stimulus  for 
the  development  of  her  own  initiative  along  various  sug- 
gested lines. 

In  addition  we  are  offering  at  the  Institute  this  summer 
three  courses  in  subject  matter  designed  to  present  funda- 
mental facts  in  a  form  to  be  most  useful  to  the  teacher  in 
Elementary  Schools  and  avoiding  much  of  the  technical 
detail  wliich  is  insisted  upon  in  courses  provided  for  the  Matter 
training  of  specialists  in  the  field  of  public  health.     The  Courses  to 
first  of  these  courses  is  in  Personal  Hygiene  and  Nutrition  Q^^ 
and  considers  such  fundamental  topics  as  posture,  exercise,  Teachers' 
bathing,  clothing,  sleep,  ventilation,  mental  hygiene,  basal     ee   * 
metabolism,  maintenance  requirements,  overweight,  under- 


160 

weight,  etc.  The  second  course  is  called  Sanitary  Science 
and  Public  Health,  and  provides  a  comprehensive  view  of 
the  nature  of  health  and  disease,  parasitism,  resistance  and 
immunity  and  the  broader  public  health  aspects  of  water 
supply,  waste  disposal,  food  control  and  public  health  ad- 
ministration. The  third  course,  Elementary  Bacteriology, 
is  designed  to  give  the  teacher  or  general  student  a  well- 
balanced  survey  of  the  nature  and  behavior  of  micro- 
organisms and  the  part  they  play  in  affecting  the  environ- 
ment of  mankind. 

The  Mak-  The  second  phase  of  my  discussion  has  to  do  with  the 
Health  training  of  special  directors,  supervisors,  or  teachers,  who 
Supervisor.  are  -j^  assume  the  responsibility  of  organizing  and  putting 
in  operation  the  health  instruction  program  for  the  muni- 
cipal school  system.  Pennsylvania  and  Michigan  are  al- 
ready working  upon  a  four-year  course  of  study  which  will 
take  the  student  directly  after  High  School  and  produce 
this  particular  kind  of  specialist.  We  are  not  offering  this 
type  of  program  in  Boston  because  we  are  not  well  organ- 
ized to  do  so.  What  we  are  doing,  however,  is  to  provide 
a  supplemental  course  of  study  for  those  people  who  are 
already  at  work  in  this  field.  The  student's  previous  train- 
ing is  taken  into  consideration  and  there  is  prescribed  a 
program  of  study  which  will  round  out  the  fundamental 
training  in  physiology,  hygiene,  sanitation,  teaching 
methods  and  physical  training. 

We  arranged  last  year  in  the  School  of  Public  Health 
a  one-year  course  of  study  open  to  people  of  four  types  of 
preliminary  training.  They  must  all  have  had  a  High 
School  education  and  in  addition  their  training  may  have 
consisted  of  (1)  graduation  from  an  approved  School 
of  Physical  Education  with  teaching  experience;  or 

(2)  graduation  from  an  approved  College  with  specializa- 
tion in  health  subjects  or  their  fundamental  sciences;  or 

(3)  graduation  from  a  Normal  School  or  Teachers'  College 
with  teaching  experience;  or  (4)  training  in  public  health 
nursing  with  school  nursing  experience.    We  assumed  that 
people  who  are  to  develop  a  program  in  Health  Education 
should  have  a  good  grounding  in,  first,  the  subject  matter 
of  physiology,  hygiene,  sanitation  and  public  health;  sec- 
ond, teaching  methods ;  and  third,  the  nature  and  place  of 
physical  activities  in   public  schools.     On  this  basis  we 
accepted  people  well  prepared  in  one  or  more  of  these  fields, 


161 

and  provided  a  one-year  program  which  would  supplement 
their  previous  training  where  additional  study  was  most 
needed.     This  course  of  study  was  offered  under  the  co- 
operative arrangement  through  which  the  Harvard  Tech- 
nology School  of  Public  Health  has  been  conducted  and  with  Training 
the  additional  cooperation  of  the  Graduate  School  of  Edu-  to  Ex^ 
cation  at  Harvard  which  includes  in  its  curriculum  courses  perience. 
in  physical  education.     The  result  of  such  a  cooperative 
arrangement  made  available  to  these  students  practically 
every  course  at  each  institution  which  had  a  bearing  on  the 
subject  of  Health  Education.    For  the  most  part  the  subject 
matter  in  the  field  of  public  health  was  secured  in  courses 
at  the  Institute  and  the  work  in  teaching  methods  in  physi- 
cal education  was  undertaken  at  Harvard. 

In  each  case  a  separate  program  was  made  out  to  fit  the 
individual  needs  of  each  student.  It  was  approved  by  the 
Administrative  Board.  In  order  to  give  you  a  better  idea 
of  the  type  of  program  undertaken  by  these  students  let 
me  cite  the  subjects  and  classroom  hours  of  a  single  student. 
This  student  had  been  graduated  in  Physical  Education, 
and  it  should  be  borne  in  mind  that  the  program  for  a 
Normal  School  graduate  or  a  nurse  would  be  different  in 
many  respects.  The  classroom  hours  indicated  in  the  fol- 
lowing schedule  include  laboratory  as  well  as  recitation 
hours : 

Place  of  Study    Name  of  Course  Classroom  Hours 

Harvard  B  1  Psychology  and  Mental  Hygiene        45 

Graduate   School     E  I  Elementary  Education  30 
of  Education 

Massachusetts          General  Biology  60 

Institute  of              Nutrition  20 

Technology               Home  Nursing  8 

Sanitary  Science  20 

Histology  and  Embryology  70 

Personal  Hygiene  30 

Physiology  160 

Infection  and  Immunity  40 

Bacteriology  50 

Colloquium  (for  training  in 

public  speaking)  30 

Industrial  Hygiene  80 

Municipal  Sanitation  60 
Health  Education  and  Practice 

Teaching  90 

City  Hospital            Clinical  Communicable  Diseases  24 


162 

In  addition  to  the  above  courses  approximately  90  hours 
were  spent  working  in  the  Nutrition  Clinic  of  the  Boston 
Dispensary,  the  Posture  Clinic  of  the  Children's  Hospital, 
and  in  assisting  at  the  physical  examination  of  children. 

This  same  type  of  program  is  to  be  continued  in  the 
future  at  the  Institute  of  Technology  through  its  co- 
operative arrangement  with  Harvard  University  and  with 
the  added  cooperation  of  the  Division  of  University  Ex- 
tension of  the  State  Department  of  Education  which  is  to 
issue  certificates  to  those  people  who  satisfactorily  complete 
the  program  of  study.  By  this  means  we  hope  to  increase 
the  number  of  adequately  trained  specialists  and  to  make  it 
possible  to  supply  cities  and  counties  with  well-trained 
workers  who  may  be  taken  from  their  own  group.  Such 
a  course  should  make  it  possible  for  any  specialist  accepted 
as  a  student  to  expand  the  work  in  which  he  or  she  has 
been  engaged  into  a  well-rounded  Health  Education 
program. 

We  may  ultimately  desire  a  different  course  of  training, 
but  for  the  present  such  a  one-year  course  of  study  has  the 
advantage  of  making  special  workers  quickly  available 
without  making  the  educators  feel  that  we  are  forcing  upon 
them  a  new  type  of  specialist.  We  hope  that  from  our  ex- 
perience and  from  the  suggestions  of  our  friends  we  shall 
continue  to  improve  this  course  of  study  and  to  develop  it 
in  the  most  profitable  direction.  You  are  all  cordially  in- 
vited to  visit  our  classes  or  our  field  work  at  any  time  and 
your  criticisms  and  suggestions  will  be  most  welcome. 

Discussion 


The  discussion  of  Professor  Turner's  paper  was  led  by 
Dr.  Anna  Gove,  Director  Department  of  Health,  The  North 
Carolina  College  for  Women,  Greensboro,  North  Carolina. 
Dr.  Gove,  in  addition  to  her  endorsement  of  Professor 
Turner's  point  of  view,  stated  that  she  also  believed  there 
should  be  a  character  qualification. 

"It  is,"  she  said,  "perfectly  hopeless  to  have  a  teacher  coming  in 
contact  with  children  who  are  to  be  taught  about  hygiene,  if  she  is 
not  a  person  of  upright  character,  and  in  almost  perfect  physical  con- 
dition. Naturally  we  expect  the  person  to  be  alert — to  be  approach- 
able— to  be  interested  in  carrying  out  all  kinds  of  health  activities. 
I  would  suggest  that  aside  from  making  out  good  programs  for  teach- 


163 

ing,  we  make  out  a  rather  rigid  rule  for  the  exclusion  of  the  un- 
suitable. 

"In  our  particular  section  we  have  to  deal  with  a  great  deal  of 
indifference  or  positive  opposition  to  the  teaching  of  hygiene  on  the 
part  of  our  students.  They  have  had  poor  instruction  in  the  public 
schools.  The  young  people  therefore  do  not  wish  to  be  instructed 
about  health,  because  they  do  not  care  about  it,  except  so  long  as  it 
does  not  interfere  with  what  they  wish  to  do."  This,  she  felt  was  to  a 
large  extent,  due  to  the  personality  and  methods  of  the  teachers. 

Dr.  Brown,  referring  to  the  varied  qualifications  that 
are  desirable  in  a  Health  Education  teacher,  made  the  fol- 
lowing comment : 

"Your  laboratory  man  and  your  scientific  man  are  seldom  able  to 
express  in  a  form  attractive  to  the  lay-reader  the  results  of  their  re- 
search, and  it  remains  for  another  group  of  people  to  dramatize  this 
and  to  make  the  dry  bones  of  physiology  and  hygiene  a  real,  living, 
vital  thing  that  will  influence  the  boys  and  girls  of  this  country. 

"I  do  feel  that  Professor  Turner's  paper  tonight  is  a  distinct  con- 
tribution to  the  training  of  the  type  of  individual  who  can  help  here. 
I  would  further  like  to  express  my  belief  that  Dr.  Small's  paper  has 
touched  some  very  fundamental  things.  If  we  are  to  produce  the  kind 
of  teachers  who  are  to  go  out  into  the  schoolroom,  and  get  over 
vitalized  health  teaching  to  the  children,  they  must  certainly  have 
the  fundamentals  that  Dr.  Small  has  laid  down  for  us  tonight.  I 
believe  we  cannot  look  in  any  different  place  than  in  the  Teachers' 
Training  Institutions  to  produce  that  kind  of  an  individual." 

Miss  Knowlton,  referring  to  the  need  of  providing  train- 
ing for  teachers  in  the  field,  said: 

"We  have  found  it  necessary  in  organizing  our  program  in  Bing- 
hamton  to  supplement  the  knowledge  of  our  teachers  and  to  revise 
their  methods  of  work.  We  had  to  give  them  something  of  the  in- 
formation of  the  nurse.  They  must  know  something  of  first  aid 
work.  They  must  see  deviations  from  normal  conditions,  as  readily 
as  they  see  a  mistake  in  arithmetic.  We  have  wanted  to  give  them 
some  of  the  fundamentals  of  physical  education.  Also  since  we  have  Increasing 
taken  up  a  new  project  like  nutrition,  it  has  been  necessary  to  give  the  Effi- 
our  teachers  classroom  methods  and  diagrams  for  that  work,  as  very 
few  of  them  had  had  any  special  training.  The  Superintendent  ar- 
ranged to  have  conferences  regularly  when  all  teachers  are  present. 
In  addition  to  that  we  have  offered  a  normal  course — in  evening 
classes.  Physical  specialists  give  playground  work  and  setting-up 
work.  Nutrition  specialists  give  nutrition  courses. 

"That,  I  think,  is  a  very  wonderful  means  of  getting  the  work 
over  to  the  teacher.  Conferences  must  be  real  conferences,  helpful 
conferences  with  a  helpful  spirit.  The  response  of  the  teachers  has 
been  very  wonderful,  and  they  themselves  are  enthusiastic  over  the 
advantages  that  they  have  attained.  They  themselves  have  greatly 
improved  their  own  physical  condition  and  happiness  as  well  as  the 
children's.  They  have  helped  children  to  have  ideas  of  health." 


164 

The  Trenton  Health  Education  program  embodies  the 
idea  underlying  Miss  Knowlton's  remarks.  To  quote  from 
a  portion  of  Dr.  Wilkes'  paper,  prepared,  but  not  read : 

A  supervisor  of  Health  Education,  who  is  primarily  an 
experienced  teacher  of  elementary  grades,  with  proper 
training  and  personality,  is  an  essential  part  of  every  well- 
organized  school  system.  She  should  be  equipped  with 
sufficient  understanding  of  modern  medical  thought  and 
practices  of  preventive  nature,  to  be  able  to  translate  this 
knowledge  into  presentable  form  for  teaching  purposes  and 
to  enlist,  with  the  cooperation  of  the  teachers  themselves, 
the  pupils'  interest  in  the  practices  of  personal  and  general 
hygiene  as  citizens  so  that  their  community  will  be  a  better 
place  in  which  to  live. 

School  superintendents  must  be  made  to  realize  that  in 
their  organizations  provisions  must  be  made,  both  in 
finances  and  personnel,  for  the  promotion  of  health  as  an 
educational  measure  of  more  than  minor  consideration,  and 
that  time,  training  and  competent  supervision  must  be  pro- 
vided for  the  teacher  to  do  her  part  in  this  work.  The  work 
of  the  part-time  physician  and  the  nurse  are  already  defi- 
nitely established  and  their  time  is  fully  occupied  with  the 
physically  defective  children.  The  maintenance  of  health  is 
largely  the  job  of  the  teaching  force. 

Conferences  with  this  supervisor  and  other  health  spe- 
cialists should  be  held  regularly  at  times  convenient  for 
teachers,  and  they  should  be  urged  to  attend.  Our  ex- 
perience in  Trenton  proves  that  the  teachers  are  willing 
and  anxious  to  correlate  health  teaching  when  they  are 
given  the  time  and  material,  and  they  have  devised  some 
excellent  methods  of  presentation  which  have  produced 
tangible  results  in  raising  the  physical  standard  of  Trenton 
school  children. 

Duties  of  What  are  the  duties  of  such  a  "Health  Educator"  in  the 

t^eaUf'  »  Public  Schools?     Of  course  these  will  vary  somewhat  in 

as  Teacher  individual  cases,  but  after  much  experimentation  we  have 

Trainers.  about  agreed  that  the  Health  Educator  should: 

1.  Keep  informed  on  modern  methods  of  health  preservation  by 
reading  articles  selected  by  the  Medical  Director;   attending  health 
conferences,  etc. 

2.  Gather  methods  of  presentation  originated  by  the  best  teachers 
in  various  schools  and  distribute  them  to  less  original  teachers  after 


165 

constructive  criticism   and  correction  by  other  selected  teachers  of 
the  same  grade. 

3.  Collect,  schedule  and  dispatch  books  on  Health  Education  as 
"circulating  libraries"  when  finances  do  not  permit  of  copies  for  each 
school  building. 

4.  List  all  sources  of  helpful  material  from  which  subject  matter 
can  be  obtained  gratis  or  at  small  cost,  and  gather  "samples"  there- 
from for  criticism  and  use  of  teachers. 

5.  Assist  teachers  in  preparation  and  use  of  health  educational 
material,   such    as   graphs   of   nutritional    surveys,   individual   cases 
studied  and  improvement  shown,  snap-shots  of  children  excelling  in 
some  health  activity,  such  as  health-habit  practice,  gain  in  weight, 
making  health  posters,  etc. 

6.  Keep   in  touch   with   other   cities   for   data,   plans,   methods, 
projects,  etc.,  on  the  subject  of  health  promotion. 

7.  Aid  in  correlation  of  health  with  other  grade  subjects. 

8.  Meet  teachers  in  groups  or  in  grade  meetings  for  discussion  of 
methods  or  subject  matter. 

9.  Assemble   and  exhibit   annually  the   best  examples   of   work 
showing  Health  Education  correlated  with  other  school  subjects,  tc 
further  cooperation  with  other  departments  of  school  work. 

Another  contribution  to  the  discussion  centering  around 
supplementing  the  training  of  teachers  in  service  was  made 
by  Dr.  Mary  Brydon,  who  described  some  special  work 
along  the  line  of  teacher  training,  and  gave  a  report  of  it 
telling  how  the  physical  inspection  of  school  children  by 
teachers  was  made  necessary  in  Virginia  by  the  shortage  of 
doctors  and  nurses  caused  by  the  World  War.  She  stated 
that  in  1918  the  Assembly  of  Virginia  passed  a  law  re- 
quiring all  teachers  to  have  a  course  in  what  was  called 
"Medican  Inspection  of  School  Children  and  Preventive 
Medicine,"  which  every  teacher  in  Virginia  must  have 
taken  by  1925.  Dr.  Brydon  was  employed  by  the  State 
Board  of  Health  to  put  this  over.  No  one  knew  how  to  do 
it.  In  Dr.  Brydon's  words: 

"I  went  to  the  Board  of  Education  and  asked  them  how  they 
wanted  me  to  work,  and  they  said  that  they  did  not  know — 'It  is  your 
job.'  I  went  to  the  Board  of  Health  and  they  told  me  the  same 
thing.  So  I  began  in  a  very  humble  way  to  ask  schools  and  colleges 
to  let  me  come  in  and  give  a  course  of  five  lectures  to  the  graduates  on 
this  hard-sounding  topic.  They  received  me  very  kindly.  The  Board 
of  Education  backed  up  the  work  by  giving  credit  to  every  student 
who  took  the  course." 

Dr.  Brydon  continued  by  telling  how  the  course  was  ex- 
panded to  ten  lectures  and,  on  the  insistence  of  the  State 
Superintendent  of  Public  Instruction,  was  made  equiva- 


166 

Training     lent  to  one  college  session  hour,  with  the  same  grading  as 

in  Virginia  other  college  subjects.    With  the  assistance  of  Prof.  C.  D. 

to  Meet  a     Hart  and  Miss  Bell,  and  the  assistance  of  a  teacher,  a  pub- 

Health         ^c  health  man,  a  physician  and  a  research  worker,  the 

Law.  course  was  finally  completed.    It  was  officially  adopted  by 

the  State  Board  of  Education  as  a  part  of  their  Physical 

Education  course  designed  to  meet  the  requirements  of  the 

West  Law.    It  is  hoped  some  day  to  see  it  named  "Health 

Education"  instead  of  "Physical  Education." 

Dr.  Brydon  continued: 

"The  subjects  covered  by  the  course  are:  Physical  defects  and 
their  control;  communicable  diseases  and  their  control;  mental  hy- 
giene; organization  of  State  and  national  health  boards.  You  will 
say  this  is  a  great  deal  to  put  into  36  hours,  and  we  know  that  is 
true,  but  we  are  in  process  of  evolution.  Every  one  of  the  29  in- 
structors last  year  complained  to  me  that  a  great  deal  of  time  had 
to  be  spent  on  physiology,  as  the  students  coming  out  of  High 
School  knew  absolutely  nothing  about  it;  that  they  could  not  teach 
hygiene  or  physical  defects  when  the  students  did  not  know  whether 
the  lungs  were  in  the  head  or  the  feet.  So  our  State  Superintendent 
of  Public  Instruction  decided  that  in  1924  one  of  the  prerequisites  for 
this  course  should  be  a  High  School  course  in  human  biology  and 
physiology. 

"I  want  to  report  to  you  how  this  was  administered  in  the  37 
schools  and  colleges  of  Virginia.  It  has  been  my  special  work  to 
get  this  course  in  every  Normal  School  and  College.  The  colleges 
were  willing  to  put  it  on,  because  their  graduates  who  had  not  had 
this  course  would  not  be  allowed  to  teach  in  the  State  of  Virginia. 
Out  of  the  37  schools  and  colleges  25  put  on  the  course.  Next  year 
11  more  will  put  it  on.  One  old  conservative  college  said  they  would 
not  put  it  on  until  1925. 

"Many  things  have  happened  that  we  do  not  like,  yet  it  is  all  in 
the  way  of  evolution.  We  started,  as  you  may  remember,  with  just 
one  ignorant  doctor  going  around  giving  five  lectures.  At  the  end 
of  this  session  we  have  29  instructors  giving  it  in  25  schools.  I  did 
not  bring  any  pressure  to  bear  on  the  way  they  should  conduct  this 
course.  The  schools  and  colleges  worked  it  out  themselves,  as  also 
did  the  Board  of  Education,  because  I  work  very  closely  with  their 
staff." 

Dr.  Brydon  stated  that  6  schools  had  put  it  under  the 
Educational  Department ;  6  under  the  Physical  Education 
Department;  5  under  the  Biology  Department;  2  under  the 
Physiology  Department;  5  under  Health,  Home  Economics 
and  Science.  As  to  the  name  of  the  course — 5  called  it 
School  Hygiene;  3  Hygiene  and  Sanitation;  5  Hygiene;  1 
General  Hygiene;  1  Rural  Hygiene;  1  Public  Health  Edu- 
cation; 1  Hygiene  and  Physical  Education;  1  School  Man- 


167 

agement;  1  Health.  They  made  it  a  separate  distinct  course 
in  all  the  schools  and  colleges  except  three,  and  of  those 
three  1  incorporated  it  in  Rural  Hygiene,  1  in  Home  Nurs- 
ing and  School  Hygiene,  and  1  in  School  Management.  Ten 
schools  offered  it  to  Seniors  alone;  3  to  Juniors  alone;  9 
offered  it  as  elective  in  all  classes. 

Dr.  Brydon  continued: 

"The  number  of  hours  that  were  given  varied,  but  those  giving 
less  than  36  hours,  of  course,  were  not  given  credit.  All  but  three 
schools  required  practical  work  of  the  students,  and  no  credit  was 
given  those  three.  By  practical  work  I  mean  actually  testing  vision 
and  hearing,  inspecting  teeth,  nose  and  throat,  etc.,  and  weighing 
and  measuring  the  children.  The  students  learned  how  to  do  it  for 
the  children  by  practicing  on  each  other.  The  State  Board  of  Health 
supplies  free  of  charge  material  for  physical  inspection.  Twenty-five 
hundred  students  took  the  course." 

Dr.  Brydon  stated  that  a  similar  course  was  conducted 
by  Miss  Bell  by  correspondence  for  the  benefit  of  an  average 
of  600  teachers  who  could  not  conveniently  attend  the 
schools  and  colleges.  She  stated  that  the  physical*  inspec- 
tion work  is  being  done  successfully  by  many  teachers  of 
the  State.  They  report  only  obvious  defects  and  advise  the 
attention  of  a  specialist.  Where  there  is  a  county  health 
nurse,  she  does  the  follow-up  work  necessary  to  have  cor- 
rections made.  This  has  led  to  the  establishment  of  many 
dental  and  throat  clinics  in  the  rural  districts. 

Dr.  Brydon  concluded  by  saying: 

"Since  Virginia  is  a  rural  State  and  has  problems  of  its  own,  only 
similar  to  some  of  the  other  Southern  States,  we  have  found  it  abso- 
lutely necessary  for  those  teaching  in  Virginia  to  know  how  to  attack 
local  health  problems.  For  instance,  we  have  to  approach  the  prob- 
lem of  malnutrition  from  a  different  angle  in  Virginia  because  of 
the  hookworm  disease,  since  sometimes  100  per  cent,  of  the  rural 
teachers  and  children  have  hookworm.  There  is  little  use  giving  spe- 
cial nutrition  work  and  talking  school  lunches  in  rural  schools  until 
we  get  rid  of  this  disease." 

Dr.  Wood  next  introduced  Professor  Flora  Rose,  School 
of  Home  Economics,  Cornell  University,  Ithaca,  New  York. 

Health  Education  for  Teachers  Through  Home  Economics 

Professor  Rose:  __^ 

IN  connection  with  this  question  of  preparing  teachers 
in  Health  Education,  quite  naturally  I  have  to  talk  from 
my  standpoint,  which  is  the  home  economics  standpoint; 


168 


Subject 
Matter 
the  First 
Considera- 
tion in 
Training 
Teachers. 


and,  secondly,  from  the  standpoint  of  the  person  who  is 
especially  interested  in  nutrition  but  who  also  sees  a  rela- 
tionship between  nutrition  and  these  other  phases  that  have 
been  discussed. 

It  seems  to  me  there  are  three  main  considerations  in 
the  training  of  teachers — any  teachers — whether  of  health, 
mathematics,  or  anything  else.  After  all,  fundamentally 
our  successes  or  our  failures  are  based  on  these  three  con- 
siderations : 

The  first  is  not  necessarily  the  most  important  consid- 
eration, but  it  nevertheless  is  the  foundation — that  is  the 
subject  matter  that  we  are  going  to  try  to  put  across.  In 
this  case  it  is  Health  Education  that  we  are  trying  to  put 
over  to  the  teachers.  In  subject  matter  it  seems  to  me  we 
have  two  large  groups  of  subjects.  The  subjects  in  the 
first  group  are  those  which  deal  with  physical  health.  In 
physical  health  the  health  teacher  should  be  well  grounded 
in  nutrition.  As  we  mark  the  teaching  of  health,  I  am  in- 
clined to  think  that  50  per  cent,  of  our  teaching  of  health 
deals  with  nutrition.  For  example,  when  Johnny  comes  up 
for  his  teeth  to  be  examined  and  we  find  that  his  teeth  are 
poor  and  dirty,  we  may  teach  him  to  brush  his  teeth,  but 
we  must  also  find  out  why  he  has  poor  teeth.  It  is  either 
one  of  two  things — either  Johnny  is  poorly  nourished  or 
Johnny's  mother  has  been  poorly  nourished  before  or  after 
Johnny  was  born,  when  she  was  unable  to  give  him  his  nat- 
ural food.  He  may  be  too  tall  for  his  weight  or  the  breadth 
of  his  chest.  It  may  be  a  nutrition  difficulty — Johnny  may 
have  those  teeth  because  he  has  not  had  the  normal  food. 
It  may  be  traced  back  to  defects  in  his  feeding  before  he 
was  born  and  defects  after  he  was  born,  so  that  we  find 
this  is  a  nutrition  problem.  In  the  training  of  our  health 
teachers  one  of  the  fundamental  things  needed  is  specific 
instruction  in  nutrition.  They  must  have  a  sound  founda- 
tion of  facts. 

One  authority  makes  this  statement  as  a  result  of  his 
laboratory  experiments  and  as  a  result  of  his  observations 
of  foreign  people.  He  says  that  he  believes  the  most  im- 
portant influences  in  producing  healthy  adults  are  four: 
First,  normal  food;  second,  right  exercise;  third,  the  fact 
that  mothers  should  nurse  their  babies  and  should  be  able 
to  nurse  their  babies;  fourth,  that  the  race  should  be 
abstemious  and  should  not  use  alcoholic  drinks.  Three  of 


169 

these  are  nutrition  problems  and  the  fourth  is  a  physical 
education  problem. 

The  subjects  in  the  second  group  are  those  which  deal 
with  mental  health.  The  best  classification  of  the  subjects 
in  this  group  would  be  social  and  educational  psychology, 
and  mental  hygiene  and  all  that  this  includes. 

As  we  watch  the  development  of  children  we  find  that 
although  the  nutrition  problem  is  such  an  extreme  one 
back  of  the  nutrition  problem  in  8  or  9  cases  out  of  10  is 
a  child-training  problem. 

Our  lack  of  knowledge  of  the  mental  sciences,  in  the 
first  place,  and  secondly  our  lack  of  application  of  those 
sciences  to  our  scheme  of  education,  result  in  the  fact  that 
the  average  human  being  knows  very  little  about  his  re- 
lationship to  other  human  beings,  particularly  the  relation 
between  parents  and  children  and  between  teachers  and 
children.  If  we  can  bring  this  mental  health  into  the  train- 
ing of  teachers,  through  our  study  of  mental  hygiene,  we 
certainly  have  one  of  the  big  problems  of  Health  Education 
under  way  toward  solution.  It  is  absolutely  tied  up  with 
these  other  problems  and  we  cannot  separate  them. 

To  recapitulate :    The  first  consideration  in  the  training 
of  teachers  is  a  sound  foundation  of  subject  matter  upon 
which  the  rest  is  to  be  built ;  but  this  is  only  one-third  of  the 
problem.   The  second  of  these  considerations  is  spirit.  We 
may  be  able  to  teach  facts  to  a  group  of  individuals  or  to  The 
a  group  of  teachers.  We  may  give  them  the  material  they  clnsidera- 
need,  but  until  we  have  given  them  the  spirit  itself  we  have  l^~t 
not  accomplished  our  result.  It  must  be  like  the  changing  of 
protein  into  protoplasm  if  we  are  to  give  this  matter  to  our 
teachers.    We  must  be  able  to  do  it  in  the  way  they  do  it 
in  Miss  Bragg's  schools.     It  is  a  possible  thing  to  accom- 
plish.   We  must  enable  the  teacher  to  transmute  fact  into 
the  spirit  that  is  back  of  the  fact  if  we  are  to  accomplish 
results,  and  she  must  be  able  to  live  her  health  subject  if 
later  she  is  going  to  be  able  to  teach  it. 

We  have  agreed  that  in  educational  institutions  you  will 
recognize  that  there  is  a  tremendous  amount  of  factual 
teaching.  There  is  very  little  of  the  spirit  in  association 
with  it.  We  find  a  great  many  facts  told  to  students.  We 
find  very  few  being  taught  by  a  teacher.  We  must  have 
the  thing  transmuted  from  protein  to  protoplasm  if  we  are 
to  accomplish  any  result. 


170 


The  Third 
Considera- 
tion— 
A  Definite 
Plan. 


These  are  only  two  parts  of  this  triangle.  There  is  still 
a  third  thing  that  is  necessary :  a  plan  through  which  we 
may  accomplish  results. 

First,  we  must  have  a  sound  foundation  of  subject  mat- 
ter; second,  indomitable  spirit,  and  finally  a  definite  plan 
and  the  ability  to  put  this  plan  through  in  some  organized 
way.  Ability,  for  example,  of  the  subject  matter  person 
to  diagnose  conditions, — to  diagnose  physical  and  mental 
health, — to  diagnose  the  needs  of  the  communities  for 
Health  Education;  then  the  ability  to  connect  a  live  situa- 
tion with  the  fact  which  is  to  be  taught,  because  until  that 
teacher  is  able  to  diagnose  a  live  situation,  and  then  make 
some  connection  that  applies  between  the  fact  and  the 
situation,  we  have  no  knowledge  that  is  potent.  We  have 
no  knowledge  that  is  workable.  It  is  a  fact,  but  it  does 
not  work. 

It  is  a  very  interesting  thing  to  me — and  here  again  it 
is  a  confession  of  weakness — to  see  how  many  years  I  have 
been  teaching  facts  and  how  few  of  the  facts  that  I  have 
been  teaching  have  been  effective.  It  is  a  most  tragic  thing 
to  watch  this  year  by  year. 

At  Cornell  we  have  finally  developed  one  method  by 
which  to  estimate  whether  results  have  been  obtained.  In 
our  Junior  year  we  teach  a  course  in  dietetics  based  on 
science.  At  the  end  of  the  course  we  have  a  Practice  House 
into  which  our  Senior  students  go  to  apply  the  things  which 
they  have  learned.  Do  these  dietetic  and  nutrition  facts 
function  in  their  lives?  I  hope  they  do  this  year,  but  they 
have  not  in  the  past.  We  have  taught  our  facts  on  a  factual 
basis  in  an  academic  way.  We  are  reforming.  We  have 
decided  to  discard  traditions — to  throw  them  to  the  winds. 
We  do  not  care  whether  we  cover  a  logical  outline  or 
not.  What  we  would  like  to  see  is  this — that  each  fact 
that  we  present  functions  in  the  life  of  the  student.  As  a 
result  of  our  experiment  there  is  no  subject  that  is  so  much 
discussed  around  the  dormitory  tables  as  the  subject  of 
dietetics — so  much  so  that  some  of  the  other  students  in 
the  College  decided  that  dietetics  enthusiasts  were  perfect 
nuisances.  Whole  Sororities  have  had  their  dietary  habits 
changed  because  the  members  could  not  live  in  the  same 
house  with  our  students  and  get  by  with  their  old  habits. 
Why  have  we  got  these  results?  Because  the  girls  have 
worked  out  their  own  problems.  They  have  selected  their 


171 

own  problems — part  of  it  is  personal,  and  what  is 
not  personal  is  as  closely  related  to  the  personal  as  we 
could  make  it.  It  actually  has  functioned — the  thin  have 
grown  fat;  the  fat  have  grown  thin.  Those  who  have  had 
indigestion  have  ]been  cured.  So  urgent  are  these  young 
reformers  that  if  a  girl  has  no  regard  for  the  selection  of 
food  she  becomes  almost  a  taboo  person;  that  is,  if  she 
needs  to  reform  and  isn't  doing  so. 

To  illustrate  how  each  girl  works  out  her  own  problem, 
we  have  one  stout  girl  who  said  the  last  day  of  school: 
"I  know  all  those  other  fat  people  are  getting  thin,  and  Working 
they  look  awfully  well,  but  I  like  food  so  much  that  I  have  i%d£!idual 
just  decided  that  I  would  rather  eat  what  I  want  than  look  Problem. 
well.    I  feel  very  well  and  don't  mind  getting  fat."    In  other 
ways  she  is  modifying  her  procedure.    She  is  a  perfectly 
wonderful  physical  specimen,  and  whether  she  wants  to  be 
fat  or  thin  is  her  own  problem.    She  is  doing  certain  other 
things  that  she  thinks  she  should  do,  as  she  says  she  has 
got  to  be  an  example  instead  of  a  warning. 

We  feel,  therefore,  that  we  must  round  out  this  triangle 
in  the  training  of  our  teachers  in  Health  Education.  We 
feel  very  strongly  that  in  home  economics  we  are  sending 
out  teachers  of  Health  Education  who  have  the  health  bias ; 
in  nursing  they  are  sending  out  teachers  who  have  the 
hygiene  bias. 

We  also  feel  that  ultimately  it  will  come  to  training  the 
community,  because  it  is  a  community  problem.  We  feel, 
in  training  teachers,  that  one  failure  of  the  teacher  is  that 
she  is  taught  to  teach  and  give  a  classroom  performance 
instead  of  learning  to  make  her  education  function  in  the 
community  through  the  classroom.  I  think  that  ultimately 
we  have  got  to  have  the  nutrition  specialist,  the  physical 
education  specialist,  -the  nursing  specialist,  do  their  com- 
munity training  through  committee  work.  If  we  use  mod- 
ern educational  procedure  and  modern  methods  in  the  class- 
room we  do  a  great  deal  of  work  through  committees.  Our 
present  methods  of  procedure  are  through  committee  ac- 
tion. We  have  to  do  that  same  thing  out  in  the  com- 
munity. We  have  to  have  this  combination  of  people  who 
are  specialists,  because  we  recognize  that  it  is  not  possible 
for  one  to  get  complete  information  in  all  these  subjects. 
The  physical  education  specialist  must  have  a  background 
in  all  these  things;  the  nutrition  specialist  must  have  the 


172 

same  background ;  and  so  must  the  nursing  specialist.  Not 
only  must  they  have  their  facts,  but  they  must  be  trained 
equally  in  this  whole  educational  side  and  in  social 
psychology,  for  each  of  them  is  going  to  meet  those  prob- 
lems as  much  as  they  are  going  to  meet  the  health  problem. 
We  cannot  get  away  from  the  fact  that  human  relation- 
ships affect  health  through  their  interference  with  health 
habits  just  as  much  as  a  knowledge  of  the  facts  of  this 
subject. 

Discussion 


Miss  Margaret  Sawyer,  Director,  Nutrition  Service, 
American  Red  Cross,  National  Headquarters,  said,  in  dis- 
cussing Miss  Rose's  paper: 

Interpret-  "I  am  particularly  interested  in  the  teaching  of  foods,  and  I  think 

ing  Science   we  have  failed  because  we  have  not  taken  into  consideration  that 

^Environ-       there  are  many  unforeseen  factors  which  always  Influence  the  selec- 

ment.  tion  of  every  diet.     We  send  girls  out  from  our  nutrition  classes 

and  we  find  them  saying,  'In  order  to  have  lime,  we  must  live  on 

vegetables,  spinach,  yolk  of  eggs,  etc.'     However,  whether  she  is  a 

nutrition  specialist  or  whether  she  is  going  to  feed  her  family,  she 

has  to  face  conditions  varying  from   day  to   day  and  from   month 

to  month  and  from  year  to  year  which  have  to  be  considered  before 

the  food  can  be  selected  wisely.    These  conditions  may  be  muscular 

activities,  peculiarities  of  the  digestive  system,  racial  and  religious 

principles,  income,  local  market  facilities,  etc. 

"I  am  reminded  right  here  of  a  worker  who  went  to  a  certain 
State  with  the  idea  that  children  must  drink  milk,  must  have  eggs, 
must  have  green  and  leafy  vegetables.  There  were  no  milk,  no  eggs, 
no  leafy  vegetables.  She  did  not  know  how  to  begin.  She  worked 
out  a  plan  so  that  a  reasonably  adequate  diet  could  be  provided  in 
the  community  with  local  foods.  In  that  vicinity  there  were  very 
few  cows — an  average  of  about  one-third  of  a  cow  to  each  farm. 
Powdered  milk  was  brought  in.  There  was  some  local  grain  and  it 
was  taken  to  a  local  mill  to  be  ground,  so  that  the  inadequate  diet 
could  be  made  adequate.  In  foreign  communities,  racial  prejudices 
and  religious  beliefs  make  it  difficult  to  arrange  a  balanced  diet. 

"Teach  foods  in  simple  terms:  Why  drink  milk?  What  are  the 
things  that  we  have  to  have  in  milk?  Are  such  things  to  be  had  in 
other  foods?  I  think  we  might  begin  and  make  a  study  of  the  lime 
requirements  for  a  day,  and  then  provide  some  sort  of  table  which 
will  show  the  amount  of  lime  that  one  serving  of  various  common 
foods  provides,  and  thus  establish  some  sort  of  practical  standard  for 
making  adjustments. 

"I  think  we  do  want  to  send  students  into  the  field  with  ideals 
that  they  can  use,  and  use  with  variations.  We  are  too  apt  to  think 
about  the  localities  in  which  we  are  located  and  we  do  not  think 
about  Missouri  and  Arkansas,  etc.  I  was  greatly  impressed  in  my 


173 

trip  to  Arkansas  by  the  extent  to  which  local  conditions  influence 
the  line  of  procedure.  Nutrition  workers  ought  to  be  well  grounded 
in  fundamentals,  and  so  be  able  to  build  up  an  adequate  program  by 
using  the  immediate  facilities  and  opportunities.  Every  situation 
can  be  made  an  opportunity  if  we  only  know  how  to  make  that 
opportunity." 


Commonwealth  Fund  Announcement 


At  the  close  of  the  session,  Miss  Jean  announced  the  sig- 
nificant offer  of  the  Commonwealth  Fund,  whereby  a  child 
health  program  in  three  typical  cities  of  the  United  States 
for  a  period  of  five  years  will  be  financed. 

Mr.  Courtenay  Dinwiddie  has  been  appointed  Executive 
Secretary  of  the  Committee  which  has  been  organized  to 
direct  the  work.  The  program  will  comprise  safeguarding 
the  health  of  the  mother-to-be,  laying  a  good  health  founda- 
tion for  children  in  the  early  sensitive  and  formative  period 
of  their  growth,  and  health  supervision  and  the  formation 
of  the  essential  health  habits  in  school  children. 

The  responsibility  for  carrying  out  this  comprehensive 
child  health  program  is  placed  upon  the  American  Child 
Hygiene  Association  and  the  Child  Health  Organization  of 
America. 

A  Joint  Committee  will  have  charge  of  all  general  poli- 
cies and  plans.  This  Committee  has  just  held  its  first  meet- 
ing with  all  members  present,  as  follows:  Dr.  Philip  Van 
Ingen  and  Dr.  Richard  A.  Bolt  of  the  American  Child  Hy- 
giene Association;  Dr.  L.  Emmett  Holt  and  Miss  Sally 
Lucas  Jean  of  the  Child  Health  Organization  of  America; 
Dr.  Livingston  Farrand  and  Mr.  Courtenay  Dinwiddie  of 
the  National  Child  Health  Council;  Dr.  Donald  B.  Arm- 
strong of  the  National  Health  Council  and  Mr.  Barry  C. 
Smith  and  Miss  Barbara  Quin  of  the  Commonwealth  Fund. 

Mr.  Barry  C.  Smith  was  elected  Chairman  of  this  Com- 
mittee and  Mr.  Courtenay  Dinwiddie  Executive  Secretary. 
The  opening  of  an  office  at  532  Seventeenth  Street,  North- 
west, Washington,  D.  C.,  was  authorized.  Active  work  will 
begin  at  once. 

After  careful  consideration  the  Committee  has  decided 
that  the  first  city  to  be  assisted  in  developing  a  thorough 
program  for  child  health  will  be  selected  from  the  upper 
half  of  the  Mississippi  Valley  region.  Two  other  cities  are 


174 

to  be  selected  in  other  sections  of  the  country  after  work 
has  been  well  started  in  the  first.  The  general  qualifications 
of  the  first  city  are  that  it  should  be  from  15,000  to  25,000 
in  population  with  an  infant  mortality  of  approximately 
100  per  1,000  live  births,  or  greater.  It  must  also  show 
a  desire  to  cooperate  in  the  work  during  the  five-year 
period  and  a  reasonable  prospect  of  assuming  responsibility 
for  carrying  it  on  in  the  future. 

Hope  for  efficient  Health  Education  rises  high  when 
such  experiments  as  this  of  the  Commonwealth  Fund,  the 
Mansfield  Demonstration,  the  Milbank  Demonstrations — 
carefully  planned,  carefully  watched,  and  honestly  evalu- 
ated— shall  go  hand  in  hand  with  planned  and  guarded 
teacher-training  courses  in  our  Normal  Schools,  where 
through  favorable  environment  and  regime,  health  becomes 
instinctive,  and  a  happy  background  for  the  constructive 
and  significant  work  of  the  real  teacher. 


Section  VI 

RECOMMENDATIONS 

VERY  early  in  the  Conference,  plans  were  made  to 
give  opportunity  for  discussing  the  papers  offered 
in  the  sessions.  In  order  to  help  precipitate  the  ideas 
thrown  into  solution  in  the  general  meetings,  and  to  crys- 
tallize whatever  conclusions  should  come  therefrom,  group 
conferences  were  arranged  to  discuss  the  general  meetings. 
Round  Table  leaders  were  chosen, — Professor  C.  D.  Hart, 
Normal  School  Group ;  Mrs.  Lucy  Paul,  for  the  High  School 
Group ;  Miss  Emma  Dolfinger,  for  the  Intermediate  Group ; 
and  Miss  Julia  Abbot  for  the  Kindergarten  Primary  Group. 
These  small  Round  Tables  took  this  opportunity  to  examine 
more  freely  and  fully  the  ideas  presented  in  the  papers, 
and  to  evaluate  them  in  terms  of  their  usefulness  in  a 
health  program  for  each  of  these  age-groups.  Most  of  the 
Round  Tables  indicated  what  they  considered  the  desirable 
characteristics  of  health  teaching  for  their  groups. 

As  a  result  of  these  small  conferences,  it  was  finally 
moved  from  the  floor  that  there  be  formed  a  general  com- 
mittee to  draw  up  a  statement  summarizing  the  findings 
of  the  Conference  and  pointing  out  what  was  considered 
fundamental  in  a  course  looking  toward  training  teachers 
for  Health  Education.  This  Committee  was  composed  of 
Dr.  Bigelow,  Professor  Turner,  Dr.  Winslow,  Dr.  Gove, 
Miss  Perrin,  Miss  Jean,  Dr.  Wood  and  Dr.  Small,  to- 
gether with  the  leaders  of  the  various  Round  Tables. 
Basing  their  conclusions  upon  the  reports  of  the  groups, 
and  the  outstanding  opinions  expressed  in  the  ses- 
sions, this  Committee  prepared  a  set  of  recommendations 
which  was  presented  to  the  Conference,  and  discussed  point 
by  point,  with  great  care.  The  recommendations  as  finally 
accepted  stand  as  follows : 

REPORT  OF  THE  COMMITTEE  ON  TEACHER 
TRAINING  FOR  HEALTH  EDUCATION 

Preamble 


From  the  reports  of  leaders  of  the  Primary,  Intermediate 
and  High  School  sections  of  the  Round  Tables,  the  following 

(175) 


176 

outline  is  submitted  as  indicating  what  seems  to  be  the 
desirable  trend  for  a  plan  of  Health  Education. 

Kindergarten,  through  4th  grade:  That  here,  primary 
emphasis  should  be  laid  upon  habit  formation,  in  a  health- 
ful school  environment.  Health  principles  should  be  em- 
phasized in  relation  to  actual  situations  and  in  the  project 
work  in  these  grades. 

In  the  5th  and  6th  grades  the  basis  should  be  more 
broadly  biological  and  should  convey  a  conception  of  the 
functions  of  the  body  as  a  whole,  although  the  content  of 
the  course  should  still  be  correlated  with  health  habits  and 
practices. 

In  the  Junior  and  Senior  High  Schools,  while  continuing 
the  effort  to  fix  the  habits  and  broaden  the  knowledge  indi- 
cated for  previous  grades,  problems  arising  from  group 
activities  offered  in  the  school,  home  and  community  should 
be  stressed.  In  these  grades  the  dominant  idea  should  be 
service. 

Recommendations  Regarding  Health  Education  for 
Teachers  in  Training 

I.  HEALTH  EDUCATION  in  a  training  school  should 

include  three  factors: 

(a)  A  Student  Teacher  Health  Service. 

(b)  Healthful  Surroundings. 

(c)  Content  Course  or  Courses. 

II.  STUDENT  HEALTH  SERVICE : 

The  Student  Health  Service  referred  to  should  include : 

(a)  A  complete  health  examination  and  such  subsequent  exami- 
nations as  may  be  necessary. 

(b)  Health  advice  and  supervision  of  students  throughout  the 
course. 

(c)  The  correction  of  remediable  health  defects. 

(d)  The  maintenance  of  a  healthful  regimen  of  living.    .    .    . 
"Healthful  living"  shall  be  understod  to  include  proper  hours 
of  sleep,  proper  food,  clothing,  bathing  and  exercise. 

(e)  As  far  as  practicable,  the  student's  attitude  and  conduct  in 
regard  to  the  above  points  shall  be  a  basis  for  recommenda- 
tion for  a  professional  position. 

III.  HEALTHFUL  SURROUNDINGS : 

It  is  recommended  that  the  administration  of  Teacher- 
Training  Schools  should  make  provision  for  supervision 


177 

and  control  of  the  living  and  working  conditions  of  stu- 
dents, whether  the  students  live  in  dormitories  or  else- 
where. 

IV.  CONTENT: 

The  following  subject  matter  topics  are  suggested,  in 
order  that  teachers  may  have  an  appreciation  of  commu- 
nity health  work  and  may  do  their  part  in  health  instruction 
to  the  best  advantage.  It  is  important  that  there  be  adap- 
tation of  these  principles  to  the  problems  of  urban  and  rural 
schools,  and  it  is  further  suggested  that  the  best  practicable 
distribution  of  time  and  relative  emphasis  be  given  these 
topics  according  to  local  conditions. 

The  fundamental  subject  matter  should  be  derived  from 
the  following  fields : 

(a)  Personal  Hygiene. 

(b)  Nutrition. 

(c)  Community  Hygiene. 

(d)  Social  Hygiene. 

(e)  Mental  Hygiene. 

(f)  Health  and  Care  of  Infants  and  Young  Children. 

(g)  Health  of  Childhood  and  Adolescence, 
(h)  First  Aid  and  Safety. 

(i)      Hygiene  of  the  Worker. 

(j)     Home  Nursing  and  Care  of  the  Sick. 

(k)     School  Hygiene. 

(1)      Physical  Education. 

(m)  Principles  of  Health  Education  and  Practice  Teaching.  Prac- 
tice Teaching  to  include  practice  in  all  types  of  contact  with 
children  incident  to  health  work  in  the  school. 

V.  THE     PREPARATION    FOR     THE     COURSE     IN 

HEALTH  EDUCATION: 

The  subject  matter  fundamental  to  the  above  course  or 
courses  in  Health  Education  should  include  general  prin- 
ciples of  applied  chemistry,  applied  physiology,  applied 
psychology,  applied  bacteriology;  to  be  taught  in  the  Nor- 
mal School  if  adequate  work  in  same  has  not  already  been 
done  in  High  School. 

*     *     * 

Following  the  discussions  attending  the  adoption  of  this  "student 
report,  the  Conference  moved  to  accept  the  term  "Student  Health  ^ 
Health  Service"  as  a  fit  phrase  to  express  the  kind  of  en-  Se1 
vironment  and  training  it  was  hoped  that  the  above  recom- 
mendations, if  followed,  would  produce  in  Teacher-Training 
Institutions. 


178 

Resolutions 

During  the  Thursday  session  Miss  McCormick  made  a 
duly  seconded  motion  that  it  was  the  sense  of  this  Confer- 
ence that  at  some  time  in  the  future  the  Child  Health  Or- 
ganization should  arrange  for  a  Conference  of  School 
Superintendents  and  Principals  of  Normal  Schools  to  dis- 
cuss the  introduction  into  the  schools  of  a  more  effective 
program  of  Health  Education.  The  motion  was  amended 
by  Professor  Turner,  who  proposed  that  a  committee  of 
seven,  to  include  the  Chairman,  should  prepare  resolutions 
regarding  this  subject,  which  would  be  brought  before  this 
Conference  at  a  later  meeting.  This  motion  having  been 
carried,  the  following  committee  of  seven  was  appointed 
by  the  Chairman  as  the  "Resolutions  Committee,"  namely, 
Miss  McCormick,  Chairman ;  Miss  Abbot,  Dr.  Brown,  Miss 
Jean,  Miss  Rood,  Dr.  Small,  Professor  Turner  and  Dr.  Wood. 

After  the  adoption  of  the  foregoing  report  on  prepara- 
tion of  teachers,  this  Committee  presented  the  following: 

Whereas,  The  members  of  the  Conference  of  one  hun- 
dred  workers  and  specialists  in  Health  Education  and  the 
Preparation  of  Teachers  are  convinced  of  the  important 
and  definite  improvements  in  the  health  of  the  school  popu- 
lation to  be  derived  from  a  practical  program  of  health 
instruction, 

Be  it  resolved,  That  the  agencies  which  called  this  Con- 
ference  endeavor  in  every  practical  manner  to  make  avail- 
able to  the  school  superintendents  of  the  country  the  benefits 
of  the  deliberations  and  the  conclusions  of  this  Conference ; 

And  resolved,  That  each  member  of  the  Conference  en- 
deavor  through  personal  appeal  to  school  administrators 
in  his  or  her  own  state  to  further  the  adoption  of  a  practical 
school  health  program; 

And  resolved,  That  it  seems  desirable  to  the  Conference 
assembled  that  the  agencies  which  called  this  meeting 
should,  if  possible,  arrange  an  International  Conference  on 
Health  Education  to  be  held  in  this  country  in  the  spring  of 
1923. 

The  Conference  unanimously  adopted  the  resolutions  as 
presented. 


The  GUESTS 

Name  Affiliation 

A 

Miss  JULIA  WADE  ABBOT Specialist  in  Kindergarten  Education,  Bureau 

of  Education,  Washington,  D.  C. 

B 

MRS.  ISABELLE  W.  BAKER,  R.N .  Director,  Instruction  in  Home  Hygiene  and 

Care  of  the  Sick,  A.  R.  C.  Nat.  Hdqrs., 
Washington,  D.  C. 

DR.  FRANKLIN  BARROWS Assistant  Medical  Inspector,  State  Dept.  of 

Education,  Albany,  N.  Y. 

Miss  ADELAIDE  S.  BAYLOR Acting  Chief,  Home  Economics  Service,  Fed. 

Board  for  Vocational  Exchange,  Washing- 
ton, D.  C. 

Miss  ETHEL  BEARD Director  in  Health  Education,  Child  Health 

Demonstration,  Mansfield,  Ohio. 

Miss  JESSIE  BEARD Hospital  Social  Service,  New  York  City. 

MR.  GEORGE  BEDINGER Director,  Dept.  of  Health  Service,  American 

Red  Cross,  N.  Y.  County  Chapter,  New 
York  City. 

Miss  MARY  I.  BELL Director  of  the  Health  Correspondence  Course 

for  Teachers,  State  Board  of  Health,  Rich- 
mond, Va. 

DR.  MAURICE  A.  BIGELOW Professor  of  Biology  and  Director,  School  of 

Practical  Arts,  Teachers'  College,  Columbia 
University,  N.  Y.  C. 

Miss  ESTELLA  BOGARDUS Executive  Secretary,  Yonkers  Tuberculosis 

Association,  Yonkers,  N.  Y. 

DR.  RICHARD  A.  BOLT Director,  American  Child  Hygiene  Association, 

Washington,  D.  C. 

MRS.  BOLT 

Miss  MABEL  BRAGG Assistant  Superintendent,  Newton  Public 

Schools,  Newton,  Mass. 

DR.  WALTER  H.  BROWN Director,  Child  Health  Demonstration,  Mans- 
field, 0. 

MRS.  BROWN 

DR.  MARY  E.  BRYDON Director,  Bureau  of  Child  Welfare,  State 

Board  of  Health,  Richmond,  Va. 

C 

MR.  HOMER  N.  CALVER N.   Y.  Academy  of  Medicine,  Public  Health 

Committee. 
MRS.  CALVER 

(179) 


180 

MRS.  HENRIETTA  CALVIN Specialist  in  Home  Economics,  Bureau  of 

Education,  Washington,  D.  C. 

Miss  MARGARET  C.  CAREY Assistant,  Child  Health  Organization,  New 

York  City. 

Miss  ADA  CARR Asso.  Director,  National  Organization  for 

Public  Health  Nursing,  New  York  City. 

MR.  LEWIS  H.  CARRIS Field  Secretary,  National  Committee  for  the 

Prevention  of  Blindness,  New  York. 

MRS.  CARRIS 

Miss  LAURA  A.  CAUBLE Bureau  of  Nutrition,  Dairymen's  League  Co- 
operative Association,  Inc.,  New  York  City. 

Miss  MYRTLE  V.  CAUDELL Director  of  the  Vocational  and  Homemaking 

Department,  State  Normal  School,  Buffalo, 
N.  Y. 

MR.  DANIEL  CHASE Supervisor  of  Physical  Education,  The  State 

Department  of  Education,  Albany,  N.  Y. 

MRS.  CHASE 

Miss  MARY  CHAYER,  R.N Flint,  Michigan. 

Miss  JESSIE  COLE Nutrition  Specialist,  A.  R.  C.,  Albany  County 

Chapter,  Albany,  N.  Y. 

DR.  CAROLINE  CROASDALE Prof,  of  Hygiene  and  College  Physician,  New 

York  State  College  for  Teachers,  Albany, 
N.  Y. 

Miss  BELVA  CUZZORT Pres.  Nat.  Assoc.  of  Ex-Military  Reconstruc- 
tion Aides,  Washington,  D.  C. 

D 

MR.  CHARLES  M.  DEFOREST  . . .  Modern  Health  Crusade  Executive,  National 

Tuberculosis  Association,  New  York  City. 

MR.  COURTENAY  DiNWiDDiE Executive  Secretary,  National  Child  Health 

Council,  Washington,  D.  C. 

Miss  EMMA  DOLFINGER Asso.  Dir.,  Child  Health  Organization,  for- 
merly Supervisor  of  Science,  Elementary 
Schools,  Louisville,  Ky. 

E 

DR.   EDWARDS School  Dentist,  Board  of  Education,  Trenton, 

N.  J. 
DR.  A.  L.  EVANS Bonneterre,  Mo. 

F 

MRS.  MARTHA  FALCONER Director,  Dept.  of  Protective  Social  Measures, 

Am.  Social  Hygiene  Association,  New  York 
City. 

Miss  HELEN  FREEBORN Washington  Junior  High  School,  Rochester, 

N.  Y. 


181 

G 

Miss  FANNIE  GERSON,  R.N Supervisor  of  Nurses,  Bureau  of  Child  Hy- 
giene, State  Dept.  of  Health,  Trenton,  N.  J. 

DR.  ANNA  M.  GOVE Director  of  Dept.  of  Health,  State  College  for 

Women,  Greensboro,  N.  C. 

Miss  AMELIA  GRANT Assistant,  Nursing  and  Health,  Teachers'  Col- 
lege, Columbia  University,  New  York  City. 

H 

Miss  FLORENCE  L.  HALL Bureau  of  Animal  Industry,  U.  S.  Depart- 
ment of  Agriculture,  Washington,  D.  C. 

Miss  GRACE  T.  HALLOCK Assistant,  Child  Health  Organization,  New 

York  City. 

PROP.  C.  D.  HART Associate  Professor  of  Public  Health,  College 

of  William  and  Mary,  Williamsburg,  Vir- 
ginia. 

Miss  JENNIE  HAVER County  Helping  Teacher,  Hunterdon  County, 

Dept.  of  Public  Instruction,  Clinton,  N.  J. 

MR.  ERNEST  HESSE The  World  Book  Company,  Yonkers-on-Hud- 

son,  New  York. 

PROF.  PATTY  S.  HILL Dir.,  Dept.  of  Lower  Primary  Education, 

Teachers'  College,  Columbia  University,  New 
York  City. 

DR.  L.  EMMETT  HOLT President,  Board  of  Trustees,  Child  Health 

Organization,  New  York  City. 

Miss  JESSIE  HOOVER Milk  Utilization  Specialist,  Bureau  of  Animal 

Industry,  U.  S.  Dept.  of  Agriculture  Wash- 
ington, D.  C. 

J 

Miss  SALLY  LUCAS  JEAN Director,    Child    Health    Organization,    New 

York  City. 

K 

Miss  BELLE  KIRK,  R.N Social  Service  Union,  Steubenville,  Ohio. 

DR.  H.  E.  KLEINSCHMIDT American  Social  Hygiene  Association,  New 

York  City. 

Miss  I.  GRACE  KLINE,  R.N Syracuse,  N.  Y. 

Miss  EFFIE  KNOWLTON Superintendent  of  Health  Education  Depart- 
ment, Department  of  Education,  Bingham- 
ton,  N.  Y. 

L 

Miss  MARION  LERRIGO Teachers'  College,  Columbia  University,  New 

York  City. 
Miss  VIRGINIA  LEWIS Director,  Modern  Health  Crusade,  Ohio  Public 

Health  Association,  Columbus,  Ohio. 


182 

Miss  MARIA  H.  LUDLUM School  Nurse,  Board  of  Education,  Bridge- 
port, Conn. 

Miss  CORNELIA  LYNE Assistant  Secretary,  National  Child  Health 

Council,  Washington,  D.  C. 

DR.  HANNAH  McK.  LYONS Nutrition  Expert,  Philadelphia  Inter-State 

Dairy  Council,  721-724  Heed  Bldg.,  Phil- 
adelphia, Pa. 

Me 

DR.  E.  V.  McCOLLUM Prof.,  Dept.  of  Chemical  Hygiene,  School  of 

Medicine,  Johns  Hopkins  University,  Balti- 
more, Md. 

Miss  MARY  G.  McCORMiCK Supervisor  of  Nutrition,  State  Department  of 

Education,  Albany,  N.  Y. 

Miss  MATILDA  McKEOWN Assistant  to  Director  of  Cooking,  Department 

of  Education,  New  York  City. 

M 

MRS.  BERTHA  MASCOT Supervising  Nurse,  The  State  Department  of 

Education,  Albany,  N.  Y. 

Miss  ANNARuTHMEDCALF,R.N.Lwe  Fork  Settlement,  Kentucky. 

Miss  MARY  K.  MORIARTY Teacher,  New  York  City. 

Miss  MARY  A.  S.  MUGAN Assistant  Superintendent  of  Schools,  Fall 

River,  Mass. 

Miss  MARY  MURPHY Assistant  Director,  Elizabeth  McCormick 

Memorial  Fund,  Chicago,  III. 


N 

Miss  BESSIE  NOYES Department  of  Health,  North  Carolina  Col- 
lege for  Women,  Greensboro,  N.  C. 

P 

MRS.  LUCY  M.  PAUL Instructor  in  Physiology,  Bacteriology  and 

Hygiene,  Pratt  Institute,  Brooklyn,  N.  Y. 

Miss  ETHEL  PERRIN Assistant  Director,  Health  Education,  Detroit 

Public  Schools,  Detroit,  Mich. 

Miss  JEANIE  PINCKNEY Dept.  of  Home  Economics,  University  of  Texas, 

Austin,  Texas. 

DR.  ALVIN  POWELL Director  of  Health  Development,  Oakland 

Public  Schools,  Oakland,  Calif.,  and  of  the 
Public  Health  Center,  Alameda  Co.,  CaL 

Miss  KATHERINE  A.  PRITCHETT  .  Supervisor  of  Nutrition,  Dept.  of  Public  In- 
struction, Commonwealth  of  Pennsylvania, 
Harrisburg,  Pa. 

R 

Miss  ANNE  RAYMOND,  R.N Associate   Director,    Child   Health    Orgat 

tion,  New  York  City. 


183 

Miss  ELMA  ROOD,  R.N Teachers'  College,  Columbia  University,  New 

York  City. 

Miss  FLORA  ROSE Professor  of  Home  Economics,  Cornell  Uni- 
versity, Ithaca,  N.  Y. 

s 

MR.  A.  L.   SAFFORD.  . , Superintendent  of  Schools,  Reading,  Mass. 

Miss  MARGARET  SAWYER Director,  Nutrition  Service,  A.  R.  C.  National 

Headquarters,  Washington,  D.  C. 

Miss  C.  M.  SCOVEL New  York  Training  School  for  Teachers,  New 

York  City. 

DR.  WILLARD  S.  SMALL Specialist  in  School  Hygiene  and  Physical  Edu- 
cation, Bureau  of  Education,  Washington, 
D.  C. 

MRS.  SMALL 

Miss  MARGARET  SPARKS Nutrition  Specialist,  Trenton  Public  Schools, 

Trenton,  N.  J. 

Miss  MARY  SPENCER Columbia  University,  New  York  City. 

Miss  FLORENCE  STOWELL Department  of  Education,  Binghamton,  N.  Y. 

T 

Miss  JULIA  B.  TAPPAN Assistant,  Division  of  School  Hygiene,  Bureau 

of  Education,  Washington,  D.  C. 

PROF.  C.  E.  TURNER Asst.  Professor,  Dept.  of  Biology  and  Public 

Health,  Mass.  Institute  of  Technology,  Cam- 
bridge, Mass. 

V 

MissMARTHA  VAN  RENSSELAER.Pro/essor  of  Home  Economics,  Cornell  Uni- 
versity, Ithaca,  N.  Y. 

w 

Miss  HARRIET  WEDGWOOD Assistant,  Division  of  School  Hygiene,  Bu- 
reau of  Education,  Washington,  D.  C. 

Miss  EDNA  N.  WHITE Director,  Merrill-Palmer  School,  Detroit,  Mich. 

Miss  ANNE  L.  WHITNEY Associate  Director,  Child  Health  Organization, 

New  York  City. 

Miss  GERTRUDE  WHITTON Secretary,  Health  Development  Division,  Oak- 
land Public  Schools,  Oakland,  California. 

DR.  LEROY  A.  WILKES Medical  Director,  Board  of  Education,  Tren- 
ton, N.  J. 

DR.  C.-E.  A.  WINSLOW Professor  of  Public  Health,  School  of  Medi- 
cine, Yale  University,  New  Haven,  Conn. 

MRS.  WINSLOW 

DR.  THOMAS  D.  WOOD Professor    of   Physical   Education,    Teachers' 

College,    Columbia    University,    New    York 

City. 


CHILD  HEALTH  ORGANIZATION  of  America 


Health 
in  Education 


Education 
in  Health 


BOARD  OF  TRUSTEES 


Dr.  L.  Emmett  Holt,  President 

Dr.  Thomas  D.  Wood,  Vice-President 
Dr.  Frederick  Peterson,  Secretary 
James  G.  Berrien,  Treasurer 
Clinton  H.  Crane 
Mrs.  Lyman  D.  Gilbert 
Dr.  Samuel  McC.  Hamill 
Dr.  Royal  S.  Haynes 
Dr.  Victor  G.  Heiser 
Mrs.  Franklin  K.  Lane 


Owen  R.  Lovejoy 
Dr.  William  Palmer  Lucas 

Mrs.  Gordon  Nome 
Mrs.  Frederick  Peterson 

Dr.  Bernard  Sachs 
Dr.  Philip  Van  Ingen 

Allan  Wardwell 
Miss  Florence  Wardwell 
Dr.  Herbert  B.  Wilcox 
Dr.  C.-E.  A.  Winslow 


Marie  L.  Rose 

Margaret  C.  Carey 
J.  Mace  Andress 


STAFF 

Director 

Sally  Lucas  Jean 

Associate  Directors 

Anne  L.  Whitney  Emma  Dolfinger 

Anne  Raymond,  Field  Representative 
Lucy  Wood  Collier,  California  Representative 

Assistants 

Grace  T.  Hallock  Alice  F.  Loomis 

Advisory  Directors 

Lucy  Oppen  Mabel  C.  Bragg 


CHILD  HEALTH  ORGANIZATION  PUBLICATIONS 


TITLE 


SPECIAL  USE 


For  the          Height-Weight  Card Gives  tables  for  boys  and  girls  5-18  years  /  age 

Weighing      Watch  Your  Weight  Tag Carries  the  message  into  the  child's  home 

Day 

Health  Child  Health  Alphabet For  kindergartens  or  first-grade  children 

Stories  for    Cho-Cho  and  the  Health  Fairy A  supplementary  reader  for  primary  grades 

Little  Rosy  Cheeks  and  Strong  Heart A  health  reader  for  the  third  grade 

People          Rhymes  of  Cho-Cho's  Grandma Application  of  "Rules  of  the  Health  Game"  in  a  child's  do 

Everychild's  Book A  new  alphabet 

Plays,  Miss  Jenkins'  Sketch  Book History  of  our  Vegetables  and  Fruits  in  rhyme,  with  ill- 

Games  and  trations  to  be  colored 

Other  Health  Plays  for  School  Children Original  plays  by  teachers  and  pupils  of  Greater  New  York 

Devices          Health  Plays,  4  in  set Offered  as  suggestions  for  original  plays  by  children 

Milk,  the  Master  Carpenter A  leaflet  of  facts  suggesting  posters,  plays,  etc. 

Cho-Cho  Health  Game A  card  game  based  on  the  Child  Health  Alphabet 

Alphabet  Cards Carry  home  a  health  message 

Songs  of  Health  and  Joy Health  songs  set  to  folk  song  music 

For  High      BirdseyeMapof  Healthland,28"x42".  .For  school  room  use 

School  Healthland  Flyer  Railroad  Folder         Describes  all  points  of  interest  in  Healthland 

Boys  and       Happy's  Vanity  Case Booklet  —  Beauty  and  Health  for  girls 

Girls  My  Health  Book. A  booklet  designed  for  adolescent  girls 

Many  Roads  to  Health A  reproduction  of  a  class  health  book 

Happy's  Calendar  (Illustrated  by 

__________         Briggs) New  Health  Epigrams  for  every  day  of  1923 

For  Health  in  Play Suggestions  for  playground  workers  and  play  leaders 

Older            Standards  of  Nutrition  and  Growth... Statistical  studies  used  as  basis  of  Height-Weight  Tables 
Folks  The  Nutrition  Class How  to  organize  and  conduct  the  class 

The  Value  of  Weighing  School 

Children Authoritative  statements  by  Dr.  Holt  and  Dr.  Wood 

Posters          Decorative  Posters,  4  in  set Offered  as  suggestions  for  original  posters  by  children 

"Rules  of  the  Game"  Poster Offered  as  suggestions  for  original  posters  by  children 

Placques,  size  1 1 "  diameter Showing  Child  Health  seal 

Healthland  Map  Exhibit  with  electric 
lights 

Price  Listjurnished  upon  application 

Order  from  the  CHILD  HEALTH  ORGANIZATION  of  AMERICA 
©-1922-C.H.O.  *0  Seventh  Avenue,  New  York  Ci* 


DEPARTMENT  OF  THE  INTERIOR 

BUREAU  OF  EDUCATION 

Health!       Strength!       Joy! 


HEALTH  EDUCATION  PUBLICATIONS 


CLASS-ROOM  WEIGHT  RECORD 

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No.  1 

WANTED!  TEACHERS  TO  ENLIST 
FOR  HEALTH  SERVICE 

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No.  2 
DIET  FOR  THE  SCHOOL  CHILD 

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No.  3 

SUMMER  HEALTH  AND  PLAY 
SCHOOL 

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No.  4 
TEACHING  HEALTH 

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No.  5 

CHILD  HEALTH  PROGRAM  FOR 
PARENT-TEACHER  ASSOCIA- 
TIONS AND  WOMEN'S  CLUBS 

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No.  6 

FURTHER  STEPS  IN  TEACHING 
HEALTH 

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No.  7 
THE  LUNCH  HOUR  AT  SCHOOL 

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No.  8 
HEALTH  TRAINING  FOR  TEACHERS 

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No.  9 

YOUR  OPPORTUNITY  IN  THE 
SCHOOLS 

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No.  10 

SUGGESTIONS  FOR  A  PROGRAM 
FOR  HEALTH  TEACHING  IN  THE 
ELEMENTARY  SCHOOLS 

Single  copy,  10  cents 
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No.  11 
MILK  AND  OUR  CHILDREN 


Posters 

No.  2 

RIGHT  HEIGHT  AND  WEIGHT  FOR 
GIRLS 

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No.  3 

RIGHT  HEIGHT  AND  WEIGHT  FOR 
BOYS 

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MATERIAL  IN  QUANTITY 

may  be  purchased  from  the 
SUPERINTENDENT  OF  DOCUMENTS 

Government  Printing  Office 
Washington,  D.  C. 

Sample  Set  Nos.  1-11,  50  cents 

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